LISFRANC FOOT

ambalish · Newbie Joined: 25 Feb 2005 Posts: 12

Hi everyone. It's nice to know there are others in the same boat, but it seems like a sinking ship. A little bit about me...

I'm a 28-year old woman. Lisfranc was diagnosed 3 weeks after a car accident which totalled my car (another driver tried crossing the highway in front of me and I hit her at about 45-50 mph). I was sent to a foot/ankle specialist in Baltimore who said we were lucky it was caught so early. I had surgery 2 days later where he inserted two screws to bring the bones back into line.

I was told my treatment would go as follows:

Surgery to put in screws. Post-op, foot is placed in a brace/splint which is then wrapped in gauze and cotton padding to allow for swelling. On top of everything is a stretchy wrap (akin to VetWrap if you're an animal person). This creates a soft cast which keeps the foot immobile.

I've been told to keep foot elevated for 72 hours and use RICE method. I'm in between this step and the next one but have found that I need to keep my foot elevated or it begins to swell and feel the burning and pins/needles sensation others have talked about.

Two weeks later I return for follow-up and soft cast comes off and is replaced by an ankle brace which will be worn for 4 more weeks (still non-weight bearing)

Six weeks from initial surgery, second surgery to remove screws. Afterwards, I will wear a boot to return to weight-bearing (my husband calls this my Robo-boot). I'm not sure how long I'll be in the robo-boot.

I go for my two week follow-up next Wednesday and my biggest concern at this point is that it seems like everyone else here was told to begin weight-bearing before the screws come out. I wonder if that might be part of what is causing the burning/pins/needles to last? Also, it seems like most of you have had your screws removed several months after they were put in. I wonder if 6 weeks is going to be long enough to make a difference.

Has anyone else had the screws taken out at 6 weeks and then started weight bearing afterwards? What were your results?

Thanks,
Anne

pseudonim · Site Admin Joined: 25 Dec 2004 Posts: 485

I think dr.lady knows all the answers Smile

dr.lady · Newbie Joined: 25 Feb 2005 Posts: 7

Injuries to the Lisfranc complex are fairly common and difficult for patients.
Delayed treatment or missed diagnosis of these injuries can lead to significant complications. Early diagnosis and orthopedic referral are necessary because operative treatment is often required.

Long-term functional results were better when the quality of the reduction was excellent.
The dislocations were divided based on the classification system its very meter. Your treatment would go if you already know the details like when you have had your screws removed or when you begin weight-bearing depends of the recovery the bone and of the dislocations classification.

A full recovery is at the end of the ninth month, range of motion of the foot and ankle was full, with no pain on daily activities. I wish you best and do not worry.

Dr.lady

ambalish · Newbie Joined: 25 Feb 2005 Posts: 12

Update:

My husband and I misheard my doctor the first time. After the original cast came off, it was replaced by a fiberglass one. I believe my next visit I get put into a walking boot. The screws will actually stay in until 4 months post surgery. So far, things seem to be going well. The burning/pins & needles stopped once my foot stopped swelling. Hopefully, I'm one of the lucky ones who didn't get long-term nerve damage.

Anne Smile

ambalish · Newbie Joined: 25 Feb 2005 Posts: 12

I'm now 2 weeks pre-screw removal. I've been weight-bearing with and without the robo-boot. I wear the boot mainly at work (I lift and carry computers all day - there's no way that's happening without the boot). I still have a lot of pain most of the time. Some days it's more of a dull ache. Other days, it's almost a constant burning/searing pain from the nerve rubbing the top of the screws. On a few occasions (sometimes it's just a few minutes), my foot doesn't hurt at all, but that's only when I'm wearing the boot.

I know the more the nerve is agitated, the more likely I'll have long-term nerve damage. I try using the boot as much as possible because it seems to limit the nerve pain. At home, I've always liked to walk barefoot, but have found with the screws in that I'm more comfortable if I walk with shoes on. Concrete KILLS my foot.

I've also developed a bad case of plantar fascitis (sp?). I think I had a little bit of this before the accident, but now it's unbearable in the morning unless I wear the stupid leg brace to bed.

My doctor assures me that I'll feel an immediate relief after the screws come out. At this point I'm more annoyed than anything. I've had knee problems since I was a young teen and since I can't "jog" down stairs with this foot, it's putting a lot of strain on my knees. I take Celebrex and Tylenol to try to control the knee pain, but it doesn't seem to do anything for my foot.

I'll post again after the screw removal to let you know my progress.

pseudonim · Site Admin Joined: 25 Dec 2004 Posts: 485

Hey Anne,

I wish you good recovery and all the best!

Let us know how was your screw removal.

Good luck!

ambalish · Newbie Joined: 25 Feb 2005 Posts: 12

Thanks Pseudonim,

This surgery was MUCH easier than the first one! Screws were removed June 17th, it's now the 21st. Not much swelling and can definitely feel a difference ...no more constant ache where the screws were. I do notice some nerve irritation when I walk or move my toes a certain way. It's not constant so I'm hoping it's just because of the little bit of post-op swelling. Actually, my bandage is causing more pain than the screw removal itself at this point because it's rubbing against the skin on my foot as I walk and my job requires a lot of walking.

I know some others have said the same thing, but I want to reiterate for anyone reading this....if you're diagnosed with a Lisfranc fracture, see a foot/ankle orthopaedic specialist immediately! When I went for my pre-op exam with my regular nurse practitioner, she was asking me about how my ordeal has gone. Then she told me a horror story about her own mother having a Lisfranc fracture in 1999 from falling off a ladder. Her mom's regular orthopaedic doc tried fixing it, but now it's 2005 and her mom still has a lot of pain and problems with that foot. This fracture really requires a specialist's attention.

I've been in my walking boot for the last 5 days and tomorrow i'm in a post-op shoe until 2 weeks from screw removal. Also, no getting my leg/foot wet until the 2 weeks is up. Then my doc said I'm good to go (I live about 2 1/2 hours from my specialist so he's letting me remove my two stitches myself at day 14). I'll post again in a few weeks to let everyone know how I'm doing.

Anne Smile

Guest · Guest

I am ten weeks post fusion for a Lisfranc injury. I sustained the injury on June 21, but the actual extent of the injury was not discovered until about 8 weeks after the injury - after 2 sets of x-rays, an MRI and a CT scan. At 12 weeks post-injury, September 14, I had a fusion of 1-3 metatarsal joints with bone graft. At one week post-surgery, my cast was removed and I was put back into a cam boot (which I used pre surgery) and started using a bone growth stimulator r/t my physicians concern about the softness of the bones. At 7 weeks, I was permitted to bear weight with the cam boot, and at 8 weeks went into athletic shoes with orthotics. Walking has been very painful with much swelling. A large grape-sized lump appeared on top of one incision area. My physician feels it could be r/t fluid, loosening of some internal sutures or a stress fracture. How common are stress fractures after previous foot injuries? What treatment is usually used? Since being on my foot more- I started back to work this week 4 days ago- I am having increased pain, especially in the outer ankle and side of the foot.

Mark · Silver Member Joined: 23 Jul 2005 Posts: 227

Guest · Guest

Hi -
Hoping someone has some advice on this -

My 70 year old mother has been diagnosed with a Lisfranc injury and is dreading the idea of surgery. Does anyone have any feedback on how they fared without having the screws inserted? Are there any alternative treatments? Does the amount of displacement matter? Hers is very slight - she is now about 6 weeks post-injury and able to get around a bit without using her boot. The idea of being incapacitated again is depressing her.

Thanks in advance.

LISFRANC FOOT

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