I sustained a lisfranc injury after a bike accident over two years ago.  I was 59 years old at the time of the accident.  I had avulsion fractures and a ~ 2mm displacement of the bones.  I turned to these forums out of desperation and fear which actually increased my anxiety about the injuries.  The injury was diagnosed by a podiatrist after an initial ER visit within 72 hours.  I was given the option of surgery, or not.  I opted for a non-surgical approach. This is a very individual decision and one that varies from injury to injury and treating physician to treating physician.  My reasoning was that if the outcome was not acceptable, I could get the surgery later on. This was a risky decision because I was advised that the healing process could take at least a year.  If the non surgical approach was unsuccessful, I was facing a second period of disability.  I spoke with a nurse who tried what I did, but then opted for the surgery after having continuous pain after a two year period of non-surgical healing. 

I was non weight bearing  and used a knee scooter for about 9 weeks. I worked throughout this period after the first week at a desk job.  I did not trust myself driving and could not because I had a standard transmission car. Throughout that 9 week period I did whatever exercises I could that were non-weightbearing. Following the removal of the cast, I had about 9 weeks of out-patient physical therapy and continued my home exercises.  I resumed going to the gym as soon as I was able.  I purchased an entire new shoe wardrobe!  I used RX crocs in the house all the time for the first year or so. I was never barefoot.  I used shower slippers.  I purchased new balance shoes, one black pair for work, one white pair for the gym.  They were not attractive.  I had a difficult time walking for quite some time.  I was not able to cross country ski 6 months after the injury.

I am now over two years out from this injury.  I am walking and cross country skiing.  I was never a runner and would be anxious about running again.  The affected foot can feel sore, especially in colder weather or when I have not been weight bearing for a period of time.  My podiatrist has said that the outcome could have easily been the same if I had taken the surgical approach.  I feel relieved that I can walk without pain.  I never really wore dress shoes, and have kept to "sensible shoes".  I suspect that I may have problems in the future, but again, I may have had these same problems with surgery. 

I hope this post offers some cautious optimism.  I want to stress that one should get as much information as one can from one's treating physician before making decisions about treatment. This is a tough injury and one can't generalize from person to person.  One thing I read was a study from the Palo Alto Medical Foundation on lisfranc injries:  Trauma to lisfranc's joint:  An Algorithmic approach   Amol Saena.  One of his conclusions: "Often a minor sprain may entail a protracted coarse of healing, straining the doctor-patient relationship.  Doctors and patients, both, often under-estimate the severity and length of disability from these injries."