Lisfranc dislocation, good news on recovery

I am glad to see someone with a healthy attitude towards getting better.

My lisfranc injury happened 5/30 this year on a bike ride. I couldn't clip out as I was crashing my bike and twisted it pretty bad! We were 25 miles out so I had to bike it 25 miles back in...

Urgent care next day, ortho foot and ankle specialist a few days after that, went home with an air cast, and MRI two days after that. The next Wednesday I had a followup with my doc and the MRI showed high degree lisfranc tear and avulsion fracture.... so off to the table the next day (6/10/10) for me and one screw later, here I am.

Now, roughly one week post op and I have been trying to take it easy - STILL NO WEIGHT BEARING :-) - Being a nurse and active adventurer I am going stir crazy! I have no pain (ok maybe a little twinge here and there but nothing major)and am thankful for my iceman cooler system that is folded into the dressing, but have not needed it for a few days.

I know it is early, but I am hoping to give some good news to those out there who have only been able to find the horror stories.

Sending some good energy out to those who need it :-) and I will keep posting as much as I can. Hopefully I will be able to at least get into the pool soon to enjoy some of my unpaid time off, lol.

I fell off the stairs a month ago and after being misdiagnosed for a month, and told its broken with a cast applied. I was told that I do have LisFranc ligament rupture, and need to have an operation. The pain and some swelling has continued throughout. Now I am trying to locate a good doctor in London, andy help would be appreciated. Also I got quite depressed when I read several of the blogs. Trying to have a positive attitude, hope pain gets less over time, and I can start walking and swimming again. Any advice much appreciated...

Sanush -

I am no where near London, perhaps your GP can recommend someone?

Just remember that this will take time to heal. I pass my time studying, reading, and trying to work out the rest of my body (arms, situps, leg lifts, etc... )

Try to take all the horror stories on here with a grain of salt. It is very frustrating but we still must eat, move, and perform other tasks just like when we were not hurt.

I use my crutches, and have stopping points where I can set my glass or plate down on the way to the table. I have a backpack that I carry around with me and use it to move things from room to room.

I also have a "grabber" that I got that helps me reach things that are a little too far away - I LOVE it.

I have a chair inside the tub (this chair is for the tub specifically) and a chair on the outside of the tub so I can transfer pretty easily.
When I had my splint on (now I am in an air cast), cast covers helped to keep my leg dry.

Ask your doctor if he can use a cooling system to put into your dressing for surgery (mine was called Iceman) - it works great on swelling and you can keep it.

Your good leg will get stronger, and so will your arms. Try to do as much for yourself as you can, but accept help when it is offered.

As far as activity, my two week post op appointment went well and the doc said I can start swimming as long as I can get in and out of the pool safely without using my bad foot at all (after the skin heals from the stitches being removed) .

He told me to get lots of rest and high quality protein :-)

Of course - you have to listen to your doctor on how he/she feels you are progressing and what activity you can actually do.

My foot still is swollen after I get up, and that is OK. When I have had too much, I just elevate it.

I am not taking any pain killers now .... and I do have an ache where the screw is put in, but I try to distract myself and before I realize it, the pain is gone.

Hang in there. Time heals all wounds. I hope this helps.

This is a good read. Had my foot injured in early July, and was misdiagnosed as a sprain. Doc just told me to elevate, ice etc. Had to ask for prescription for crutches. My sister had a boot she gave me. So naturally, after a few days, life's little moments makes me put weight on the boot. A month later, go back to have it xrayed again, and a new doc, refers me to ortho. Ortho says "lisfranc" and does a CT scan. Scan is wrong angle, so has the CT done again. 4mm displacement of 2nd metatarsal. Confers with 2 other docs but schedules for surgury Sept.1. No surgury finally, but two more months non-weight bearing. Now, leg muscles getting atrophied but pain is manageable, so long as no weight on it. No pain killers. Massaging, some stretching with the boot off. Just hope I'll be able to walk on it normally again. And bike. Starting to wear shoes again, after taking out the insoles. Anyways, this thread encourages me to persist and be patient. My 3 year old is a handful and he wants his old daddy back so he can wrestle with him, again. :O)

Good luck all, and prompt recovery : I've read lots of good outcomes for lisfranc injuries. But it takes time and time is on my side. Yes it is.

Glad to hear that so many people were diagnosed early on...I wasn't so lucky. I am a teacher in an alternative school and was breaking up a fight in my classroom on 11/01/2010, when I was tripped and injured my foot. Went to urgent care the next morning due to SEVERE swelling and bruising. I was unable to bear weight. Doc told me it was a sprain...told me to ice and elevate...gave me crutches...told me to come back if it wasn't better in a week or so. Four days later, my foot was ice cold, blue-grey, and STILL severely swollen...went back to urgent care...they couldn't find a pulse so they sent me to the ER. This was a work-related injury so I had to go where work's insurance company told me to go. Went to the ER where they decided to stick a HUGE needle in my foot to check for compartment syndrome and then proceed to tell me it is still JUST A SPRAIN...then they referred me to an orthopedic doc. Finally got permission from insurance to go to the ortho doc...five days later! Went to the ortho doc and he also told me it was JUST A SPRAIN...gave me a fracture boot...and gave me even more serious pain meds for the pain...told me to come back in two weeks if it wasn't better. A week later (week 3) I went back to the ortho practice (this time seeing a different doc in the practice) for the new onset of numbness and continued coldness and SEVERE pain (even with pain killers). This new doc decided to cast my foot/ankle in the position of least discomfort. A week later, a follow-up (saw the first ortho doc)...he said it was still a SPRAIN...my husband and I begged him to do further x-rays or other imaging...had not had that since the visit to the ER. He did the x-rays and agreed to an MRI...that came more than a week later. Went back for another follow-up (after the MRI) where he still insisted that it was a SPRAIN! Again, my husband and I told the ortho doc that this was NOT a sprain, reminding him of the continued and more extensive numbness...he finally consented to a CT and nerve study. Now, at 6 weeks from the date of injury (and Christmas just next week), I have CT results in hand that verify at least two fractures, at least one dislocation, a tear of the lisfranc ligament, and a possible tear of one of the muscles in that region. And, after the nerve study, I have those results too...nerve damage in my foot and leg. I called the doc to speed up getting this fixed...they said that I have to wait at least another week to see the doc so that he can wait for the reports to get to him...no matter if I have the results IN MY HANDS!!!!

So, as I have been stuck here at home (on crutches for 6 weeks already) I have been doing research and reading to find out what the prognosis will be and what will have to be done to fix the problem. And as I read, I hear about probably surgery with at least 3 more months in a cast and non-weight bearing for up to 6 more months?!? Plus the potential for permanent disability resulting from the nerve damage and late diagnosis?!? I hope things go more quickly and that healing times are comparable to everyone else's healing times. I can't wait to get back to work!

I was on a cruise on November 30, 2011 at Grand Cayman when a 15 ft wave hit me and knock me off a cement pier and I fell into some coral rocks.  My foot was caught between the rocks and I fell forward and then the wave pulled me back bending my foot back.  I was in instant pain with welling to my foot and could not bear any weight on it.  I wrapped, iced and elevated the next day we were in Jamaica and I didn't want to miss out on the Dunn River Falls so I took three advil and climbed the falls with the help of my kids and husband.  I stayed off no weight bearing the rest of the cruise.  When I got home went to Doctor he said lisfranc dislocation stay off for two weeks. My husband's cousin flew in for an early family Christmas party he is an ortho doc at UCLA looked at my foot and said don't mess around get into an orthopedic ankle foot doctor.  I called to make apt. they put me off two weeks due to holidays. My friend that is  Nurse said don't wait any longer call Dr.Morgan at Tosh clinic he will see you today. She was right when I mentioned Liscfranc joint injury they had me in that day and two days latter I had surgery.  The doctor was real concerned that it might be to late beacause I was 4 weeks out from injury.  I guess the sooner the repaired the better.  He did weight bearing e-rays that is the key.  They found that I had a dislocation in the first metatarsal and a fracture on my second.  They put three screws in my foot to hold the complex joint together.  It didn't hurt to bad when propped up but when I got up it felt like the crews were ripping through my skin.  Ice machine was the best thing for me to help with pain.   I stopped taking pain medicine after fourth day.  I was still in pain not to bad but medicine messed with my bowls to much and I hated how they made me feel tingly all over and shallow in my breathing. The doctor said that sensation of screws ripping through foot is normal and it will be alright.  I guess it is from the blood pooling to the foot causing pain and pressure this went away after ninth day. I had a hip replacement on my left side that is why I fell funny trying to protect my right side on the fall.  Sorry to say but this injury is far more painful and longer non weight bearing recovery than a hip replacement. Went in after two weeks with soft cast.  They said everything looked great and my swelling was very minimal.  The key is to take it easy only get up to go to the bathroom keep foot up above heart. I think the pain med's give a false sense of no pain and you can over do. They put me in a hard cast and said to stay off no weight bearing for 4 weeks and keep elevated to stop swelling. I'm into two weeks now. Trying to stay busy and not get discouraged.  I have been doing some leg lifts to keep muscles strong.  I hope that after all of this I ca walk normal and ave no pain.

It sounds like a lot of us lisfranc-ers are very active.  I fractured 3 bones in the lisfranc joint 8 weeks ago on a mountain bike crash.  The radiology report from the day of the break was negative (i.e., no evidence of fracture).  I even had a physician with whom I work look at the films and he saw no fracture either.  I then went to my podiatrist that same evening and he immediately saw a "bone fleck," which was enough evidence for him to suspect a problem.  By then the swelling was so bad that he and his resident actually thought I might have compartment syndrome because my skin was cold to the touch starting at around my ankle through my foot.  I had fairly mild pain though given the severity of the break so I guess I was not as stressed about it as were they.  At any rate, I had a CT the following day and the displacement was not significant enough to warrant surgery.  Based on what I'd read online at that point, I though I'd be through the ordeal in no time because I didn't require an operation!  That was until the surgeon told me I had 4 weeks total non-weight bearing with an overall 6-8 week recovery time.  Like many of the writers on this topic, I started losing it after about 7 days and found myself doing what I refer to as the "arm bike" at the gym and doing whatever I could to lift weights.  When I was given permission to go partial weight bearing at 4 weeks, I immediately got into the pool and started with just 30 minutes of laps.  I highly recommend swimming if you have access to a pool.  When I started physical therapy last week, the therapist noted that I had very good strength and reasonable flexibility given I'd been 7 weeks without 'using' my foot at all.  I attribute that directly to swimming 4-5 times per week for the 3 week partial weight bearing period. I also noticed that the black bruising went away within just a few trips to the pool.  So to add to the spirit of hope here: I got back on my road bike yesterday for the first time in 59 days.  I am definitely with sore foot today, but it was the most enjoyable ride I've ever had.  59 days seemed like forever but of course I never realized what intricate, delicate, and sophisticated machines our feet are.  Hang in there, everyone!

update June 23, 2012. I had my three screws removed on April 30, 2012 instantly felt better and the swelling was not as bad but still have to deal with swelling. I have only used ice for the swelling and elevation no anti-inflammatories. I am walking today with little pain in my first metatarsal and the ball of my foot. I think that it is stiff and sore from lack of movement when using boot. I feel better still painful when up on it and walking all day but I am able to go shoping and get things done. I have been swimming and this has helped with the muscle strength. I am feeling better and seeing the light at the end of the tunnel. It will be another couple months before I am completely back and I hope the pain will completely go away. I did walk two miles today not to bad.

Lisa Tom ; How are you doing now? My Lisfranc injury was repaired after 3 weeks. Only took 2 screws to repair. The hard cast from ORIF comes off this week and then another 6 weeks NWB. Did you ice the hard cast during the first two weeks. Did you have PT at all?

Thanks for your words of wisdom.

How were you able to negotiate getting in and out of pool? I am 6 weeks post surgery and have been basically house bound, but doing bed exercises with small weights, sit ups, leg lifts. Would love to get into a pool, but have to wear the boot at all times. Did you swim without a boot?

I'm glad to hear someone with positive news. Thank you.

Jeff, correction... I assume you swam without the boot, but I am surprised that it didn't injure your foot.

Waitingforlight,

I'm a bit farther down the road to recovery, but just wanted to touch bases with you. I had a plastic ice 'bladder' that was placed under the cast with hoses running to the top, then quick disconnected to more hose, ending in a cooler with ice. A little motor kept ice circulating. Doesn't sound like you have that arrangement, but I would recommend icing. I am 6 weeks post surgery and still ice often.

Take care and please post. I'm trying to find someone to communicate with regularly.

This process can be depressing if we don't have hope and encouragement.

Lisfranchope: I haven't been using ice for two weeks after surgery. The dressingand cast seemed hard, and not likely to benefit too much. I'm trying to look forward though. Some days I have a lot of swelling. One day there was no swelling and I thought the fiberglass hard cast would cut my skin - super uncomfortable. I had to return to pain killers. The next day the foot swelled up again and the dressing and cast felt fine. A couple of days it swelled up so much at my ankles and foot, my toes were like little sausages sticking out of the dressing and cast. Most days were fine. I am going out today, so I have been taking Ibuprofen. Many people report a long period of swelling. While ibuprofen can be taken, and is a wonder drug, there are side effects and warnings to consider. I am looking into ice packs, cooling systems, etc. because of the benefits of icing with or without compression. When my dressing and hard cast come off this week, I will have a boot and be NWB for 6 weeks. At the appointment, I want to ask the OS about icing in the boot, wearing the boot overnight, etc. I am happy to read some positive stories. There is an Olympian who recovered from Lisfranc and competed in London. It seems reasonable that I can return to walking without pain or a limp and some jogging. My guess is the people who recover well don't blog all that much.

 

Waiting for Light.

waitingforlight,

Thank you for responding! I'm glad you mentioned ibuprofen! My doctor told me absolutely do not take ibuprofren. Apparently bones don't mend well when taking it! So I take Tylenol. I did take the pain meds prescribed after surgery, but found myself getting quite grumpy on them after awhile. Ice and elevation helped me so much with the swelling. My doctor also advised a small ice pack inserted into sock tubing and tied behind the knee to cool the blood entering the foot. Now I use this method when I'm going to be away from the cooling system for long periods.

The EB cooling systems can sometimes be purchased used on ebay. I just bought one for $70. It has an attachment for the knee, but I bought the foot attachment from my doctor. I really recommend it. It helps tremendously with the swelling. Please keep posting. You are my first lisfrancophile friend! Take care of yourself. Thinking about you. Em