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are there any alternative treatments for lis franc fractures in the foot besides surgery? Is an orthroscopic procedure available? What are the probabilities one would heal if left to the body's natural process over time? I was injured when an Oak tree fell on me last January. It went undetected until just 2 weeks ago.I was told I had a bruised bone and it is more painful than a break. I believed them until I got fed up and went to a far away town to another specialist. Now the recomendation is surgery. I'm not very confident about surgery, but can't ignore the problem either.


suggestions/moral support/ all accepted

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Hi MizzMaggie, welcome to the Lisfranc club! Follow these links for a lot of information. The first link is 14 pages full of information and the second link is because the first link got too full.

Some weblinks state that only 1 out of 55,000 persons present with a lisfranc injury so we're a rare breed.

https://www.steadyhealth.com/topics/lisfranc-foot&name=LISFRANC_FOOT&postdays=0&postorder=asc&start=0

https://www.steadyhealth.com/topics/lisfranc-foot-fracture-thread-part-ii

Kelly
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I suffered an injury to my foot because due to a car accident during labor day weekend. I was later diagnosed with having a Lis Franc injury. :-( From the 2 foot doctors I went to see, the only 2 options seems to be surgery or do nothing at all and experience arthritis later in the future which will lead to bone fusion. I wish this injury did not have to involve such an invasive procedure. Physical therapy will do little to help the pain I am experiencing. I am finally deciding to have surgery in December. :'( Does anyone have any stories to share? Did you have an overnight stay in the hospital or was it an outpatient procedure? What medication were you on after the procedures? How do you cope for 8 weeks with a cast? After the pins are removed, how long do I wait before I start my physical therapy? How long will physical therapy last?

Camille
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There are many variations and severity of lisfranc injuries.If you are having fusion of metatarsals 1,2 and 3, I can speak to that with respect to surgery and aftermath. :cry: I am 6 mos. into this drama and the light at the end of the tunnel is visible. Assuming you have had surgery, yes, it is one of the most painful experiences. I kept on trying to minimize pain meds within the first 4 weeks--probably the worse thing I did. If you are bedridden for 2-3 weeks, let your caretaker know that others need to take exceptional care of you as the meds limit what you can do(flat on your back---beyond belief!!!) and and even ask for! Get a shower cover for your leg, a shower seat, and change the head of the shower to the hand held type. KEEP that leg ELEVATED ABOVE HEART for first 3 weeks and then as needed!!!! Once up out of bed get the roll a-bout scooter if u can afford(ask dr. or medical supply store). It allows freedom of movement that crutches and walker do not. I used the walker in the beginning and moved to the scooter. I never used crutches--too afraid of an accident on them. Non-weight bearing is horrific--few people will understand. If u are young don't expect much sympathy--friends are clueless. You will find out who your friends are!!!!

I have 7 screws(fusion) and 3 pins(broken metatarsals4,5). Pins came out after 12 weeks(xray), hard cast back on until week 18( cat scan ), PT began week 20. First weight bearing, and I mean not a single step or pressure on the foot in any way, occurred week 14 in hard cast with orthopedic shoe over hard cast starting with up to 40 lbs pressure using a scale to step on. Frequent cast changes may be required based on your swelling levels. I had terrible swelling and still do! If you are one of the lucky non-swelling foot types you will experience less pain and PT will go much more smoothly. There is a boot for icing once the cast comes off--ask your surgeon. Icing the lower leg, ankle and foot may be necessary. For me the ankle and the foot swell with use .

The PT process is going well. Level of mobility will be better determined at 8 mos. Surprisingly, the mid foot is not too bad but getting those muscles engaged there is fifficult and the exercises very subtle. At 6 mos I am walking without a cane at home, use a cane for security outside, walk upstairs much more easily than down(still do the stiff leg down). My limp is decreasing as my ankle movement increases. I still use shower a shower seat.

Hope this has been helpful. It is truly a life-altering event but one learns to appreciate the small things again. If you have any questions please followup. :D
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Hi, I feel i am going to be one of the gloomy people on this page who are fed up with this type of injury. I fell down one stair in May 2006, heard a huge pop, thought i was going to pass out. I had to get a taxi to the A&E in the middle of the night because the pain woke me...
I was mis-diagnosed on initial consultation and referred to a fractur clinic several months later when i still couldn't walk without limping or pain. Ever time i go to the fracture clinic I have the same conversation.... I am in pain, my foot is deformed, i can't wear high heel shoes (most traumatic), I am limping etc, they nod sympathetically and I leave. I was on crutches and in an air boot for sometime, experienced a lot of muscle wasting even though I was still managing to cycle everywhere, I found this easier than walking. I had a further appointment last week and asked for further investigations or a second opinion and now they are listening to me. I am awaiting my orthotics and fusion surgery. At this stage I don't think the orthotics will help much as the top of my foot is constantly pushing against my shoes - soft and flat. The idea of non weight bearing for 6 weeks is pretty challenging... will i ever get back into high heel shoes and a pain free life?
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hello everyone. if anyone's out there. i've heard people explain that since this injury is so rare that the posts are few and far between. what i wish....is someone who is running around out there with this injury would come to this forum and say "hey!" i had this happen and i totally forgot about it because it doesn't even bother me. wouldn't that be nice? wouldn't it be nice to be walking, running, and dancing (expecially in high heels) with ease!! well, i got two screws in 2 weeks ago i just had the cast put on, it was 30 days before the doc detected it and i had walked around on it. Thank God it wasn't longer. So if anyone's interested. i looked up some famous football players who have recovered from this injury:
Warrick Dunn (i was so excited couldn't believe it...got it in '03 doin great)
Duce Staley (went on to rush for over 1,000 yards within 2 years)
Chad Lewis (his ligament was severed completely and he's in practice)

dunno maybe that'll help someone. it helps me. yea so i'll be non-weight bearing for another 12 weeks (fun) most of my vacations are screwed (no pun :-) lost 2 jobs, can't get my 15 year old around to her things, can't drive. i'm a runner and a dancer. i'm told maybe i'll never run...maybe i'll run a marathon. i think they key to this injury is keeping a great attitude..some books that have been helping me.... You can heal your life by louise hay and ask and it is given by esther and jerry hicks.
before this injury i was the most negative person on the face of the planet....i can't afford to be that person anymore, if i wanna walk up right again....the doctor's shooting for 95 percent...i'm shooting for 100...hope you do too.
much luv to all.
d
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Hi Everyone,
Never thought I'd be part of such a rare and selective group as the Lis Franc Club. I am now just able to read these postings without crying and wishing I could relive--and redo--the night I broke my foot.
I'm 12-days post-injury. I hopped off a 3 foot retaining wall, landed wrong, and fractured my left 2, 3, and 4th bones in the midfoot--with lots of little pieces floating around in there as well. Went to the ER next day for X-rays. My husband is an ER physician and had the entire staff review my x-ray--all mis-diagnosed me with merely a 2nd cunneiform fracture. Went to orthopedic doc two days later and she ordered CT which revealed the Lis Franc fracture. She and three other ortho docs reviewed the CT and recommended that I have pins put in for stabalization. It looked like I had no displacement.

So, went to Ortho surgeon for pre-op exam (old school guy with terrible bedside manner, i.e. "I just had a young women your age die from a blood clot after a simple surgergy to repair an ankle fracture." Gee, thanks for letting me know that...) Anyway, he had me do weight-bearing x-rays. These scans showed that I have a 1mm displacement. So, now he's recommending that I have screws put in. Also, back to the bedside manner, he told me that even with surgery, that my outcome will likely not be good, and that I'll probably have to have a fusion done in a couple years.

So, I'm thinking this: Why not let it heal naturally...see how I turn out...and then if there's chronic pain, etc., just go ahead and have the fusion and be done with it? One surgery instead of two. Make sense to me. Or maybe I'm just freaked out by all the recovery horror stories and I'm trying to talk myself out of the rationale solution. These last 12 days of non-weight bearing seem like an eternity to me (we are virtually helpless in this state--can't carry a glass of water from Point A to Point B!). And with surgery, you get "no credit for time served" and have to start at the beginning again in terms of recovery...

I'm going to get a second opinion. It can't hurt since I was diagnosed so quickly, I have a little time to think. I feel like surgeons are maybe too apt to recommend surgery as the fix. I'm hopeful for a more conservative treatment. I'm pretty young (35) and in good shape. I spend 50% of my day with foot elevated...ice it now and then...and try to stay active on crutches the other 50%...Today was my first day with no pain meds...but, will probably take one at bedtime. I may be naive (and I'm sure that there are many of you who are months and months into this and who think that I am...) but I'm trying to stay positive and hope that positive thinking (Kinda like that book The Secret, but no quite so hokey...) will speed up my recovery.

Like others have said, this injury has changed my life--in only 12 days--I can't imagine the kind of (better) person I'll be at the end of these next long weeks and months. I know that already I'm more patient (you have to be)...I appreciate the little things more (like working up a sweat to get to the couch, and then having the ceiling fan cool me off)...and the feeling of being clean after the arduous effort it now takes to take a shower...and feeling grateful that I don't have an even worse injury...and having compassion for those who live with major disabilities. Isn't it great when someone rushes ahead to hold a door open for you? I don't know if I ever thought to do that before for someone else. I will now (when I'm able).

With such a grim prognosis, I look for silver linings all the time. My temporary handi-cap sticker good thru Nov. I laughed when I got it that I wouldn't need it for THAT long> ha ha! Not so funny anymore. My kids (8 and 12) are going to learn to be more independent, that they can't fight like cats and dogs to get things done, and that moms need to be taken care of too sometimes...I hope this helps make them better people like I hope it makes me a better person. And again, I've slowed down about 150mph, I appreciate the simplicity in accomplishing small tasks and I can't try to accomplish 101 things in one day..and why should I and why did I ever try? The house will eventually get picked up, though not always on my schedule, and that's okay, too. One thing I can do is sit on the floor, fold laundry and watch The Sopranos.

Okay, now I'm babbling, and I don't even have the excuse of having taken a pain pill. Back to the beginning thesis of my posting and what I would like to hear from you about is whether you think healing naturally might be viable versus surgery and my idea that if fusion is virtually inevitable (according to my Doctor Doom) then why not skip the screws, see how I do, and then fuse myself later?

Cheers and Godspeed to all of you!

Heather
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I totally know how bad that sux. i'm sorry...guess its heather...but you did have me cracking up a bit. yea i was so pissed after 30 days of thinking it was not a lis franc injury that it actually was..i needed surgery...and had to start my "time" all over. well i got a few of those cheap rolling chairs from walmart and didn't put the back on em...so i can get around and carry stuff... the box says not to be used as a wheelchair, but i've found that if i roll backwards and the thing topples over i land on my butt....i was going forward...then fell forward onto my foot....so i made a mental memo to myself, thought i'd share it with you. yea this sux. i guess try to enjoy the downtime. i know that's practically impossible to do when you find yourself crawling on the floor just because its easier. %-) my doc is not making a big deal out of it...which i cannot understand. i think he learned from my crying episodes in the few weeks before my surgery. now i've had the surgery, i'm out of the splint, out of the cast, now i'm in a boot and the top of my foot still feels funky like it did before. makes me wonder if the screws are doing anything. the doc says it looks all good tho. well, yea actually the book...you can heal your life can be pretty hokey too...but if you read it while yer on the pain killers...it makes so much sense.. ha haha a XD just kidding. it had some great inspirational stuff in there, but it also had this bizarre chart of what's going on in our minds that bring on our injury's.... now i am totally not about this kind of quacky c**p...but i didn't have much else to do, but take a look at it. well, it must be really hard to deal with two little ones like that hope they're good little helpers. well, good luck and if anyone out there has ever used the air cast ... let me know. thinkin bout dippin the nearly 300 dollars for the thing. my foot is skinny as a chickens and they got this monster KISS boot on me that is strapped as tight as it'll go and i can practically pull my foot out the top.
well best of luck
denise
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oh my god. i thought i was going to be OK. not diagnosed till week 8 - and had walked on it as was told "nothing " wrong. Now have had screws put in and 1 week post operation. I thought it would be OK after 8 weeks but reading all these it doesnt seem as it will be. I am a marathon runner - now resigned to hoping to go skiing again.
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I am in week five post- op. Plenty of time to pray and to understand and like my children'sa favorite nick and disney shows ( on one episode of "Drake and Josh" Josh drops a basrbell on his foot and needs sugery, I wanted info so badly, I wathched it 4x, no help. I don't find America's funniest home videos funny anymore as I have found a new and profoundly deeper appreciation for the sufferin that injured people have.
I don't know where anyone is but if you happen to be near Las Vegas I recommend Dr. Hugh Selznic (both a trauma and orthopedic Doc 1 of 500 in the states)He is the most down to earth man with a bedside mannner that is oldfashioned(super kind and talented), The man should by my experience of people with such credentials have a huge ego...but is the nicest Doc I ever met I also recomend Keith Klevin Institute of sports and dance rehabiltation also here in Vegas for physical Therapy. I have been there for a previous injury ACL (supposedly the most painful recovery..next to LizFranc that is like getting tickled! I would encourage everyone out there to look to God & Christ to help them in through the healing process. He has never let me down. I will be praying for all of you and wherever you are pray thet you will have a God picked surgeon that can help you heal through manipulation under anethisia or ankle block to full blown surgery. We all will be kinder better more empathetic people once we recover ( or sooner) if we choose. The Bible say that "by His(Jesus's) wounds we are healed and that we can do all things through Him (again Jesus) that strenghtens us. I can't wait until my kids get back from there visit with their dad for summer I sure could use their help.. I haven't has a real shower since june 13th... tired of sponge baths and washing my hair in the sink and destroying my house with the wheelchair but....Praise God I have a house and kids and all the really other good things and even though I'm tired I'm thankful things could be far wosre. ;-)
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Hello all, I hope that everyone is healing well and I am keeping my fingers crossed that things have gotten back to "normal" for everyone.
I am now 4 days post op and so far so good. The first day after was pretty rough with the pain and all but I have been hanging in there. I had 2 screws put in and also had a bone graph done as part of my lisfranc fusion. Doctor told me that it went well and that I should recuperate well. I will be non weight bearing for at least 8 weeks if not more and that is driving me crazy already. I am spending most of my time in the bedroom because in order to go anywhere else in this house I have to go up and down stairs. That is too difficult for me. I did crawl up the stairs yesteday on my knees cause I couldnt take being in this dungeon anymore. It was nice to be out of this room and maybe I will do it again today. I jsut wanted to say hello and I will keep everyone posted on my progress
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After 31/2 months of my foot not healing and misdiagnosed, I went to a orthopedic surgen where I got diagnossed with a lis franc break. When I saw him he wanted to do surgery right away but when he found out how long it had been and that my pain level was merly a 1 he said "lets not do it" does this sound right? I was all for no surgery because my husband is leaving to Afghanisan and I have a 12 yr old boy. I'm really frightened he did mention either way I will have pain because of arthritis. Has anyone gone without the surgery?
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If the pain is tolerable, don't have surgery.
I had surgery to fix arthritis pain i was having, and now im in more pain. I can do less that i could before the surgery.
I had the surgery because i wanted to get back to my real job and to dancing. Neither has happened, and now i can't even walk properly.
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Hi all,
Looking for some advice...

I fell and suffered the dreaded Lis Franc injury almost 4 months ago. 5 screws later...I'm finding that I am timid to walk because it still hurts so bad. I'm out of the cast...and aircast....I've been told I can wear a regular shoe. Problem is...my foot is still so swollen on the top that it won't fit into any of my regular shoes. Any suggestions? A post-op shoe, maybe? Orthopedic shoes? Any hope that I will one day be able to walk normally again? I'm not in any type of physical therapy. Should I be? Any suggestions about what I should do about the shoe situation? What should I be thinking about doing with winter coming? Should I wear one "regular" shoe on the left foot, with an orthopedic shoe on the right until I heal a little more? Should I consider a cane to help? What about dress-up clothes/shoes? What has anyone done in that situation? Please forgive me...I'm having a tough time over here! :-) Nonetheless, I am certainly thankful that things are not worse than they are, and am grateful to God for that!

Thanks, eveyone...
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Hi Teful1,

Okay im going to try to give you as much advice as i can from my experiences.

4 months after my surgery February this year (midfoot fusion graft with 3 screws, injury in Sep 2007) i was no where near where i had hoped. I could walk, however i was in a lot of pain. I couldn't walk from one end of the house to the other without wearing very cushioned shoes and being very careful and slow. My foot also was swollen ontop, and i was in and out of the walking boot all the time. When i wasn't in the walking boot, i managed to fit into a pair of joggers(with the laces very loose). I also had jelly like inserts i found at the chemist which supported the arch of my foot. Regular hard orthotics will put you in a world of pain for no reason. Can you get a jogger on? If not buy a cheap pair that are too big for you and just use the one for your bad foot. The sooner you get into a supportive cushioned shoe the better. Otherwise you will start to have back, hip and knee problems. Once you fit in a more regular lace up, go and get the most cushioned stiff black shoe you can find. You will need these, trust me. Joggers are not always appropriate.

You need to walk as normal as possible, but go as slow as you need. The style of your walk is most important. Take slow small steps instead of bigger ones while limping. I don't want to upset you, but 7 months after surgery i still can't walk properly, and my doctor has given up. I too had no physical therapy, and once i get my job situation under control i will start to explore these options myself. Along with acupuncture and anything else i can find. However knowing the injury i have a feeling physio won't help a great deal. Walking properly comes first, then push the joint and ligaments. I don't want to go to a physio who will push my foot to far, and then i can't walk the next day...

When i had to dress up (friends wedding etc) i first had to wear my boot and put black on teh other leg so it didn't stand out too much. When i was out of the boot i wore my trusty black shoes and nice pants. Or black tights and a skirt over the top. It's not ideal but atleast they blend in a little better. Now i can actually wear a pair of 2 inch platforms i bought, but i have added thick padding under the ball of the foot. Also they have a strap that runs down the center which covers my scar. The only time i can wear these is f not much walking or standing is required.
And please don't get into eth habit of not going out cause you don't know what to wear. I did this and it is very isolating and depressing. No-one cares if you can't wear nice shoes or dresses with heels. Be a bit more inventive and focus on having a good time. I used to love dancing at clubs, ut now that i can't i avoid places with a dace floor. Because the last thing you want it to be stuck alone while everyone dances.

If you want to ask me any more questions feel free. Im more than happy to help

Regards, Lisa

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