Is full recovery possibe from a lisfranc fracture?

Thanks for the reply! It's always nice to meet people who have been there. I'm so sorry about your arthritis. I consider myself very lucky so far. I think what I find hard at the moment is not knowing what to expect since I haven't had a follow up appointment since September! My surgeon just said to book an appointment when I have issues lol...Thanks for your advice :)

Hi Melissa & all other l/f sufferers.

My accident happened in July 2011

I missed the top stair & to stop myself from falling down the whole lot i slammed my foot down,i knew immediately that i had done something serious,I can not begin to describe the pain!!

To cut a long story short i was diagnosed through a CT scan,I live in the UK & they dont so such scans willy nilly so i guessed i had done something serious(Apart from the obvious agony i was feeling).

I too had an ORIF procedure,I have never heard of fusion,what is it?

To this day i can not bend my foot,i sleep with a pillow under it, my big toe doesn't bend,i also suffer with the constant swelling & nerve pain,i have had 2 xrays in the past 6 months because of the shooting pains i still get. It has ruined my life,due to being in an air-cast boot for 4 months my spine went out of sync,i now have a herniated spinal disc & degenerative lumbar disease. I take that many tablets that i cant function properly. I can no longer drive a manual car, I have to wear a size up in shoes,i will never wear high heels or even kitten heels again,i bought a pair of wedges thinking they would provide more support,how wrong was i!! I fell over as soon as i left the house! I'm so paranoid about injuring the foot again,it rules my life,no longer can i walk around a supermarket or a shopping centre,i shop online. I am a Mum to 6 children,the youngest is 5 years old,i haven't taken her to the park since she was 3,it devastates me to think one stupid act of forgetfulness ended up with my life being turned upside down!!

 

Oh boy. Sadly, it sounds like you've joined the club. Your symptoms and issues are all so terribly similar to many of us lisfrancers. The problem with this injury is that it changes your life forever, that's for sure. You said you hadn't heard of Fusion and I wanted to talk to you about that surgery. It won;t make your foot perfect but it may help some. I had fusion almost 9 months ago and basically the doc fuses the joint (no joint any more) with pins/screws to reduce pain, but also function. The result is less direct pain in the joint but possibly gradual pain in supporting joints and still nerve pain. I have pain in other areas of my foot now that were not painful before and the nerve pain has actually increased rather than decreased (I had calcaneal osteotomy as well though). I honeslty could not imagine not having fusion. I could barely walk before fusion with all the arthritis (which comes quickly with ORIF) so fusion was my only option. I'm not saying it's the shining star in all of this but it is better than living with the ORIF pain. Let's just say that after this type of injury you can not expect to ever be pain free or walk normal, high heels or anything pretty is certainly out of the question! ;) In terms of your back, I get it. Me too. My back is a disaster. Comes with the territory. I really hope you are able to come to terms with this injury, that it will change your life, that it is debilitating, that it takes hold and consumes you, but I also hope you find some peace with it. It's a shitty injury, for sure, but modifying your life (as I have had to) is the key to persevering. GOOD LUCK!!!!!! :))))))

I am not sure if I am the new guest? Anyway, I suffered a bad crush and dislocation 5 years ago. Humpty Dumpty was put back together again, and things where OK. Could walk with only Dansko shoes and ride a bike with stiff shoe/cleat. But as time went on the pain on the upper Mets got terrible. So bad that I had a fusion days before Christmas( worse time to have surgery , no one is thinking about your foot).

Anyway, I had it on my terms. Light sedation with local anesthesia, went home the same day, no boot, no internal fixation. The doc did it all with an external fixation device. I did get a Staph infection on my leg which was scary but still all and all, you start walking right away.

I am walking around now or I should say shuffling as I am not suppose to bend the foot , and 5 weeks out with the external fixator attached to the upper part of my foot.

Anyway, I was wondering if anyone had the fusion done this way? External. And how long it took them to heal.

E

A lot of doom and gloom on here.. for me the surgery and 4 month on crutches was terrible, but after 5 months i saw good improvement.. by 8 months i was really good to go.. a year later, it gets stiff but i barely think about it.. can still dunk a basketball at 41 years old too.. :) ..stay off it completely for 1st 4 months.. then start running at 6..

I decided to join so as not to confuse:)
Thankyou Melissa
That is interesting as i really did not know there was another option available re my foot..I will ask my GP about fusion as he will eventually get tired of sending me for repeated Xrays no doubt!!
I came to terms with my injury a while ago now,it does however rule my life,i cant run,i cant walk fast,i have a slight limp & i cant bear to be in a room with lots of people for fear of them stepping on my foot!! I shop online for everything even food shopping,i made a trip to Ireland last year to visit family,i had to be taken up to the aircraft in a very scary disabled lift because im terrified of stairs!!
Good luck to you too:)

Wanted to provide some positive feedbacK- I had my lisfranc surgery about 3 weeks ago. First 2 days were the worst. After that minor pain. Jump to today and I'm still in a hard cast that is supposed to come off next week then I will be in a boot. I have no pain and no more swelling. My big toe is still a little stiff but everyday I can bend it more. I started going back to work and gym on crutches! So so far I've had none of the major issues many seem to have. Doc said screw will come out in 2 months. My advice is stay off it the entire time doc says to. Also keep it elevated basically 24/7 after surgery and for first 2weeks after. I'm wondering if I will experience pain once I'm allowed to take first steps?

Does get better... I'm 5 months post op from surgery, started weight bearing around Thanksgiving and I've slowly progressed to now walking in shoes.  I did purchase a couple pairs of new shoes w/ hard soles (hiking boots, walking shoes and a pair of Keens).  I also read on another blog that compression socks helped so I did get those and have not had much swelling.

My foot is still painful but I continue to see progress each week, not necessarily day to day but looking back I think each week is a little better than the last.  There are certainly days that hurt more mostly when I've done too much.  

Things that helped: physical therapy and constantly doing the exercises at home, walking laps in pool at the gym, stationary bike, icing, massaging foot and ankle a couple times a day

I can now walk, at a slow pace, 2-3 miles on the treadmill and have started some additional balancing exercises and weight training that the physical therapist recommended.

I'd be interested in hearing from others about your decision to remove hardware.  I'm really not interested in another surgery.  I've talked w/ my surgeon and he can't really give me a definite that it will help to have it removed - says it helps some, others no difference.  I've decided to wait and see how it goes for next few months.  He said I would need to make decision by summer if I want to have removed.  lmk if you have a thought on removal.

Good luck to everyone, it does get better...

 

What kind of physiotherapy exercises were you given? i wasnt put on physio so have been trying out different exercises on my own.. Im 9 months post now and am back to reasonably normal apart from swelling and stiffness and limited movement sometimes. Just interested in what exercises you have been doing.
As for me I had my hardware removed 4 months after it was all put in. I had 4 plates across the top of my foot with 13 little screws holding them in place. I didnt really think much about not getting them out since it was what my surgeon suggested and said was normal to do. I guess depending where it is it could be a comfort factor or mobility issue. Would leaving the hardware in there cause stress on other joints? :) the surgery to have hardware removed was much easier, i was put under but only had 2 weeks off work and could weight-bare straight away, i started walking after a few days. that was 5 months ago and havent had any issues! If the plates were left in I dont think I would have returned to the range of motion i am at now and am still working towards! Hope your recovery continues to go well x

Thanks for your response. I do not have plates, only screws so that might be the difference in having option to leave in but thanks again for your input. Trying to weigh the pros and cons and leaning towards getting back to work and normal activity and seeing how it goes.

On the exercises, I know it sounds stupid and I'm sure you've seen some posted on these blogs but these were helpful for me:
- picking up marbles w/ toes
- if you have access to a pool I have spent a lot of time walking laps, concentrating on putting equal weight on both feet and pushing off of my bad foot (I was nervous at first about even being able to get in and out of pool on the ladder but it really wasn't a problem at first I could manage only using my good foot and arms, now I can go up and down ladder w/ using both feet)
- stationary bike
- I purchase a couple of 10 minute yoga DVDs and try to do one each day; I'm still not very good with a lot of the moves especially if you have to point or put weight on only one foot but I think they have helped overall in keeping everything moving
- ankle - my ankle has been a big problem because of being immobile for so long it is very stiff and sore
- tracing alphabet with your foot in the air
- with yoga bands - put around your forefoot and then pull with your hand in the opposite direction that you are moving your foot to add resistance (i.e.: pull towards you w/ the band while pressing your foot down like you are pushing the gas pedal) - I keep a yoga band in the family room and when I sit down to watch the news or tv show I just run through all the exercises - do each for about 20 times (4 directions) and then repeat
- going downstairs is a problem for me so I've been working on that ankle movement (at the gym I take one of the step exercise things and put it on the floor w/o any height and do step ons and off) - sounds easy but my foot doesn't move like that!
- balancing exercises
- w/ Bose ball try to balance on both feet making sure I apply equal pressure on both feet
- stand on flat side of Bose ball and rock front back; side to side (each direction about 20 times and repeat)
- stand a few feet away from a wall and put your good foot up on the wall, balancing on your bad foot, bend at the waist and arms out to side; hold for about 20 sec and repeat a few times - make sure you but equal weight all over your bad foot

Hope these help. My surgeon wasn't really all that positive about physical therapy but for me I think it has helped the most in my recovery. I'm not normally a paranoid person but this injury has me nervous of course. The PT is quiet good at telling me what I'm feeling is normal and giving me different movements to help whatever is sore for that day - seems to be a different part of the foot all the time :)

On your swelling you really might want to try a pair of compression socks. I've been using them everyday and haven't had much swelling unless I over do it for a day.

Best of luck with your recovery and thanks again for the input on removal.

Thanks for those exercises! I have been doing some tiptoe raises and balancing things because i wasnt happy with just being discharged and told to exercise, but not really any direction.. not happy to stay at the level of recovery i am at and want to get some movement and strength back in that foot!
I do wear compression stockings to work because i am standing all day. before my removal i was wearing them everyday and they were a godsend, but its the middle of summer and stinking hot! lately my swelling is a bit better. still there but i get by by wearing an ace bandage.
im 9 months post accident now, coming up 10 and aiming to do a 19.7km hike on the anniversary of my break! managed a 10km walk today. so it gets much easier with the correct footwear.
All the best with the rest of youre recovery and whatever decision you make re hardware removal :)
Esther

I had a severe lisfrank break and dislocation. I had surgery six months after the initial injury where they not only put in pins and screws but cement to supposedly fuse everything. (these were not the only bones broken) Two and a half years after surgery I can tell you this much.....I have to wear excellent cushioned shoes (my favorite ..men's Fila's because of the extra cushion, they last longer and they give you more width than even a woman's wide and lets be honest, that foot will always be wider due to the injury. ) if I am going to have to walk more than 1/2 mile. High heels are now COMPLETELY out of the question (unless you are real careful and only wear for 10 min for an interview or something) regular shoes will eventually leave me in pain by the end of the day. I am in fairly good shape and have found I can now do just about anything else (except running as too much, impact and pressure on big toe and leaves calves extremely painful by end of day.) I have also already started to get arthritis in my foot. HOWEVER, I can still lead a full and productive life. I just have to be aware of what will put pressure on that area and my big toe (as your big toe is what helps balance you. I was honestly told I probably wouldnt ever be able to walk without a cane and I havent needed one in over a year. Yes, it limits you but as long as you emotional accept those limits, dont overdo it, keep up the exercise, you should not experience any pain other than minor discomfort....(those tennis shoes really help and they look a whole lot better than orthopedic shoes!! Granted they are not high heels, but think of it this way....you will be saving your hips and back from further issues. I am very active, I just had to learn to do different activities that did not involve putting pressure on that area.....all in all, I am just glad I can walk again and isnt that the most important thing?

Hi Saltwater,
wondering how you are doing now with your recovery. My son just had surgery and it is a breath of fresh air to hear good news for someone having surgery later after initial injury as is the case with my son. He had surgery 3 1/2 months after initial diagnoses was a stress fracture of 2nd met at base but they didn't catch that until 6 weeks out. He had 1 screw put into place to close separation between 1st and 2nd met he is young and an athlete, so we are hoping for a full recovery to play soccer eventually. I am going to look into the massage and swimming aspect after he is cleared. thank you for posting some realistic and good news his is a mild injury but still has a pretty big screw in his foot will have it taken out 3 months nwb... did you use a scooter?
thanks,
Sally

Deal SalQuaDun,

I wanted to say good luck with your son! I also had a lisfranc fracture in June 2011 and ORIF in August 2011. I understand about doing surgery later. It does like like you son's is mild since he only got one screw. Swimming does help alot. I did alot of PT in the pool. A good idea is to find a PT place with a pool, but also shop around to make sure you find an PT therapist who is knowledgeable about lisfranc fractures because they are a complex and rare fracture. Also try and have him do PT right when he can to make it strong. Also have him follow the instructions of the therapist. He might have to do work outside of PT to make the foot and leg stronger like going to the gym, but make sure he gets clear instructions on what he can and cannot do at the gym.

Unfortunately I was not so lucky as my case was pretty bad. I got my lisfranc June 2011 and broke the 1st met, a bone chipped off on the 2nd met, and then dislocated. When I had the surgery in August I had a plate and 7 screws placed in. I ended up in a cast and boot for 5 months and crutches for 4 months. Then in March of 2012 I had the hardware removed because I was in constant pain even after the first surgery and they thought taking out the hardware would aleve the pain. But after the second surgery, the pain just got worse. I ended up developing severe arthritis, my joints were deteriorating, one of my bones was out of line, cysts, bones spurs. It was terrible; I was in excruciating pain all the time and didnt walk well. I decided to see a new doctor and after trying every non-surgical option they decided to do Joint Fusion. I had that November 2012. Now I have 2 plates and 14 screws. But I have to say it has been much better situation this time around. The pain is much better. I am barely in any pain. I just started to walk with a boot and occasional assistant from the crutches. For me the fusion was the best decision. That was my happy ending to a terrible experience. I might not have the same motion in my foot, but its better than chronic pain. But it also has to do with I have an amazing doctor now, and had a terrible doctor who did the first 2 surgeries.

Sorry to tell my sorry, but had to tell someone who would understand.  But have faith, you son with listening to the doc and PT can play again as many I have read have gone back to sports. Its just a slow recovery and does take time. Tell your son to have patience. Good luck!

Thanks for the advise I'll pass it along, good luck to you!
smiles,
Sally