Lisfranc Foot Fracture Stories-part 2

An update from me:

I got clearance to get out of the boot and got fitted for some custom orthotics last Thursday. I have been walking in them for a week + with no pain or anything. I go down stairs at a normal speed, even.

Right now the prognosis looks good. I am supposed to do light workouts in the pool and on the elliptical / exercise bike to strengthen my calf and ankle for now, with a possible clearance for running in a couple of months. I have no pain right now really, sometimes I feel a little twinge here and there with a lot of activity but that's it. I even was able to walk around and shoot baskets (no jumping) last Friday which felt great.

It is a bit challenging to find footwear having 1 foot substantially larger than the other. I don't have much swelling from what I can tell, but I think I have a good portion of scar tissue. It prevents me from being able to flex my big toe upwards right now. I have no clue whether this will be permanent or not. THat's the only real negative to report for now.

Hang in there everyone.

It's interesting how different we all are -- and the truly ingenious ways in which we managed to get injured!
My injury dates back almost 30 years. Like many, my injury was misdiagnosed as a sprain. I was living in New York, had no medical insurance, and so had no follow up.
The injury eventually healed -- I had a big bump on the top of my foot but I could walk and later ran10K races, biked 100 miles at a time, and had no real difficulty.
That was then.
Last fall, the bump on my foot began to move to the side and the arch began to collapse.. A surgeon who saw my foot said "you didn't get that from a sprain" and sent me to have a CT scan and Xrays. Anyway, I ended up with a reconstructive surgeon in Vancouver and I'm having surgery Sept 12. (My choice to delay the surgery because that's when my husband and I can both take time off.)
The fortunate thing is that I have some time to prepare. I'm taking yoga to improve my balance and practcing getting about with crutches.
I have a new super-duper laptop and I'm planning on using it to edit all the vacation video we've never done anything with. I will probably build a couple of web sites too. These are things I'll enjoy but never had the time to do before.
On the other hand (or foot) I'm quite anxious about the whole thing. Worried about the amount of pain, etc.
I found a great web site where I woman discusses her ankle fusion surgery and how she prepared for it and her recovery process. Really helpful to me. I don't know if I'm allowed to post the link so I won't until someone says it's OK.
I've read all the messages in both of the lisfranc threads. It's scary AND encouraging. I'm determined to do whatever's necessary to get back to walking comfortably again. (I want to go back to London & Paris -- great walking cities.)

Hi - it's so amazing that I read your post because I came to this forum to inquire about people leaving their screws in after surgery. If anyone who has their screws still in place would like to chime in, please do!



I injured my left foot in Jan. '07 and had three screws (or pins) put in. The cast came off in late March '07 and I chose to leave the screws in for a while because they weren't bothering me and my doctor said they would help the foot become stronger. Long story short...my husband lost his job and, consequently, our health benefits before I could make a definite decision about removing the screws, so they're still in my foot over a year and a half later. I don't have any problems from the screws, per se, but my foot does bother me just generally now and then. Ironically, summer time, with the heat and humidity, is worse!



I have to say, though, that I seem to be doing better than you describe. I will limp occasionally (my mother loves to point this out, which annoys me to no end, lol) but I do pretty much all I did before the stupid accident that caused all this. Like I said, the heat of summer makes it ache more so I kind of have to take it slower, but I managed to hoof around on several college trips with my daughter last summer and did all right. Fortunately, I'm able to wear "real" shoes again; it was difficult last summer and it was miserable. I'm not 100% by any means, but I'd say I'm close to 90% back to "pre-accident." I will say it was the worst experience, physically and mentally, of my life thus far. I just did my best to think positively, not listen to the horror stories, and stuck with my therapy (which helped tremendously). Have you had therapy? Are you wearing an orthotic of any kind (insurance refused to pay for mine so I decided to forego it and just buy really good shoes). Are you still seeing your doctor? I'd love to hear how you're doing now.

I suffered my lisfranc injury on june 18 of this year, with the surgery on june 30th of this year. I similarly have three screws in my foot, but according to doctors, they will not be removed. this has been a nightmare for me. coupled with a lack of insurance and the prospect of not being able to bear weight until sept. 30th of 2008, and potentially not walking "normally" until jan. of 2009... i literally dont know what to do. i have been combing the previous posts and sincerely feel everyone else's pain. the pain has finally began to subside since being released after the surgery, but now, the potential of chronic pain, arthritis, etc. etc. etc.... as well as hospital bills is overwhelming.

Has anyone else gotten the tightrope instead of screws?
I severely dislocated all 5 metatarsals, but somehow I didn't manage to break any of them. The closed reduction was far more painful than the injury or the surgery, but fortunately everything "popped" right back into place. Surgery was performed a week later to let the swelling go down.
OS put in 3 pins to stabilize the foot and a tightrope to replace the lisfranc.
Pins came out 5 weeks post-op. Began partial weight bearing in boot at 6 weeks and am now full weight bearing in boot at 10 weeks.
I see my OS next week and hope to be able to ditch the boot then.

After reading this forum, I feel as though I am very fortunate to be where I am at this point. My arch gets a little sore after walking on it, but that's to be expected.

If anyone is researching this injury, I would encourage them to ask if the tightrope would be an appropriate treatment option. It's made by Arthrex and you can find info online about it.

Best of luck.

I completely understand your frustrations and concerns. Sitting around for several months, unable to bear any weight was really difficult for me. As I said, I just had to force myself to remember that "this too shall pass" and it would come to an end, at some point. It's not a piece of cake, by any means, but I kept reminding myself it could be a lot worse and that I would be up and walking at some point.



The main reason I didn't have my screws removed (besides being a big chicken and being scared to death of anesthesia and another surgery,lol) was that we lost our health insurance last fall and I know no new insurance company will cover any pre-existing condition for at least another year. There's no way we can take on the expense of that surgery and recovery ourselves. I'm sorry for your added stress of hospital bills.

After breaking the fifth metatarsal on Memorial Day weekend ..we had just taken off the the black boot and my sone proceeded to do a soccer "trick" and fell instead with his foot twisting and turning under him and terrible pain. They said it looked like a first second met fracture but that was 4 weeks ago. He got out of the cast on friday and can bear no weight onthe left side of his foot still. He had some xrays yesterday. His orthopedist said she wants more (an oiblique view also) Since we are so far out I am wondering why it is still so bad. I asked her through email yesterday if he had a lisfranc injury..she just said she needed more views and wanted to look at other foot to compare. He is 6 years old. Where is th epain with a Lisfranc injury and what happens if we are this far out from the original injury?

Hi,
First, I am so sorry for all that all of you are going thru, and will be praying for complete healing and pain cessation for you all! Thanks for sharing your stories!

This is a bit long, but here goes my story and concerns:
My husband fell from a skimboard while we were on vacation at the beach last Tuesday and severely twisted his foot. Immediate severe injury and not able to stand on it at all...foot also appeared to have higher midpoint than the other at the bony top portion (immediately). The foot started swelling immediately, and since we were on the beach, he had to put some weight on it (while leaning on something) to get the 150 or so yards back to the condo. Went to Urgent care 3 hours later because or his pain and inability to stand on it and the severe swelling (it was scary)...xray showed fractures to both 2nd and 3rd metatarsals at the base, w/ possible third smaller fracture in 2nd metatarsal in the middle, as well. Urgent care referred immediately to Ortho Specialist, saying it was a severe and even rare injury and would need further evaluation. All they did there was put on an Ace bandage, advise us to get a post-op shoe, and get crutches. We did that immediately. He didn't even take any of the narcotics they gave him...had pretty achy soreness and severe swelling and throbbing, but not severe pain. Iced it on and off and elevated for a few hours, but he still insisted on going out to dinner that night (on crutches w/ the shoe, etc.)

Still not in severe pain the next day, and he saw ortho that morning and was told the fractures were stable on Xray and examination, so to just keep it elevated and iced until we got back home to see a local Ortho. Said would be fine for us to stay thru the rest of our vacation. They also put on a cotton stocking type thing and wrapped w/ cotton gauze, and then a compression Ace bandage to the knee, and told him to keep the shoe, but coudl be removed for showering. Well, he still insisted on going out on the beach, only iced on and off, etc. Still only taking Advil as needed for discomfort! Anyway, we were thinking we'll get home and they'll put him in a cast and that will be it for a few weeks (based on the first ortho we saw).

Well, we got to the local ortho Monday, who immediately started voicing concerns about possible lisfranc injury or other injuries due to the location and nature of the fractures in both the 2nd and 3rd metatarsals, but also said it appeared stable in the Xray. Also gave hubby permission to drive (it's his right foot) in the acebandage and shoe and/or w/ his left foot-even though he was having to travel 5 hours both ways for a work trip this week! And even told him some slight weight bearing if he is tolerating it is okay! (evidently, my husband has an incredible tolerance for pain...he had been putting some weight on it since day 5 after the injury!). Bruising and sweeling are still quite severe but swelling is subsiding some...bruising under arch all the way thru to all his toes, which is consisten w/ lisfranc injury, also has bruising on the outside near the soles, etc. Anyway, he had a CT scan on same day as ortho appt. to determine whether there is further damage not showing up...the ortho had said the severity of his fractures sometimes indicated there might be multiple other smaller fractures and dislocation that just didnt' show up on the xray...said it takes considerable force and trauma to the foot to cause the type of fractures he sustained, and that associated soft tissue injuries and even other fractures needed to be considered. He said this is just precautionary, but now I am scared to death because of all I've read. Husband is now on his work trip...argghh...promised not to bear weight but I just can'tsee how he can keep from doing so w/ his suitcase, computer bag, getting around in and in and out of the office and hotel, etc. He says he has very little pain at this point still, so who knows?

Anyway, my question is whether anyone has ever been told it's okay to bear even slight weight this soon after injury, w/ out a cast or airboot or anything...especially if even more serious injury is suspected. Also, if he is doing this well pain wise just one week post injury, should we opt for conservative treatment even if the injury shows up as more severe on the CT scan and they recommend surgery? He travels that far (driving) every week, and seems to think he's going to just be able to keep moving thru this injury. He is manager on this project, and it will be very, very hard for him to take much time off w/out putting his job in jeopardy. He Hasn't really stopped much at all, other then physical activity.

Thanks...I'm just really scared now about what might happen w/ this...can't imagine him being in bed for 30 days after surgery as some have indicated here! The ortho told us the surgery can be very complicated and is considered major, even for a minor lisfranc dislocation....so there you have it. I am so mad the 1st ortho was so nonchalant, even though the urgent care dr. was very concerned from the beginning. Also, the concern about possible serious complications (i.e. compartmental syndrome) was never even mentioned to us. We would probably not have even known what was going on! He's now 8 days post-injury, and we see the dr. on Friday to get CT results and treatment plan.

Thanks, and sorry to be so long...

Igrem,

I suffered a lisfranc fracture from a wakeboarding accident on 6/7 and normal x-rays (including weight-bearing x-rays) did not show the injury. Only after a CT were the doctors able to see the lisfranc fracture/dislocation. I had pain during the initial 5 days after the injury but then began walking on it with an ortho boot with almost no pain. Surgery was eventually performed on 7/7 and two screws were put in along with several rods that protrude from my foot in order to externally fixate the area. I'm told that I will be in a cast for 3 months, then 1 month or so of PT, and then I should be back to surfing, running, etc. Hopefully your husband does not have a lisfranc fracture but you will find out definitively when you receive the results of the CT scan. With respect to him walking on it in the meantime, my doctor specifically told me not to walk on my foot during the period prior to my surgery bc the fracture/dislocation could get worse. That said, bc i was in relatively little pain, I continued to walk on my foot prior to surgery but i don't think it caused any additional damage. Plus, i figured that if i had to get surgery anyhow, how much more damage could i cause, right? regarding your question concerning taking the conservative approach, due to the fact that i had relatively little pain in my foot when using an ortho boot i sought opinions from several different surgeons and all of them said that i needed surgery in order to stabilize my foot and continue an active lifestyle. That said, from what i understand, it all depends on the severity of the break/dislocation which you will know from the CT if your husband indeed has a lisfranc fracture. If he does have a lisfranc fracture, hopefully he has short term disability insurance at work because i have been out of work since my surgery and am finally going back next week on a part-time basis (and i just have a boring desk job). Best of luck!

After reading many of the posts, it's sad to hear that so many people struggle to recover from their lisfranc injuries. I'm optimistically hoping that most of the folks who have previously posted their stories eventually recover well and just forget to post a follow-up message letting everyone know how great they're doing!

I just posted a message above that briefly describes my injury but wanted to ask if anyone else has had there lisfranc fracture "externally fixated"? I thought i was getting surgery to just put a couple of screws in my 1st and 2nd metatarsals and the doctor ended up also putting 3 rods that stick out of my foot which look like something from my erector set that i had as a little kid. Are these rods the same thing that people are referring to when they say they had "pins" put in? In any event, they are extremely uncomfortable and I can't wait to get them out. Can anyone tell me how painful it is when they are removed?

February 1st, 2008 I was in a head on car accident. I was miss diagnosed and waited 6 weeks to get correct diagnosis of divergent Lanfranc fracture-dislocation (he said it was a keystone dislocation) and ultimately surgery. I had open reduction and 2 screws fixation. Non weight bearing for 12 weeks. I also developed RDS (nerve damage) so I was not in a cast. I had physical therapy 2 times a week the entire time. Now, I am 20 weeks post surgery and still having moderate to sever pain. My doctor recommended fusion. He also told me to get a 2nd opinion since it will be another 6 months off my feet. I have an appointment on the 5th of August. I am debating on weather to do it regardless of 2nd opinion. Just because I know I will be better, not a maybe you will be better. Any thoughts or advise?

Well I saw the doctor today. He recomends fusion. He wants to have CT done to see extent of DJD. Says I have alot of Arthritis.

Thats what I am going through. I posted my story before, but I had surgery and a year later am still having pain...dr says I have arthritis and the swelling that I still have is causing pinched nerves. I am going to get my second opinion today...

Just thought I'd check back in after being gone for awhile. Had surgery 7/29--six months after my original injury-- to have five remaining screws removed. I'm back in my boot until the stitches are out and my foot actually fits back in a shoe again, but the pain I had through the arch of my foot seems to be gone now. While the screws were in and I was walking on my foot, I always had intense pain and pressure through the arch of my foot--it felt like my foot was about ready to snap in half. Wearing inserts in my shoes or shoes with a lot of arch support helped, but I was in constant pain and I could not walk without a limp. I return to the doctor in a week to get stitches out and then hopefully will be out of my boot soon, walking mostly limp free.

Many have posted questions concerning orthotics, etc. My surgeon is a fan of the green Superfeet insoles. They made it possible for me to wear my Nike running shoes again. An additional benefit has been that the back pain I've had for years has dissappeared. I've also become a huge fan of Keen and Privo shoes. Ok, they aren't necessarily the best looking shoes, but they feel great on my feet and both accomodate my feet that are definitely two different sizes right now because of my swelling. I used to only buy shoes that were fairly inexpensive, but these have saved my life and are worth every penny.

The one question I still have is about scar tissue. Does anyone have any suggestions about how to get rid of it? I have so much scar tissue along my large incisions that it has tied up the tendons or ligaments that lead to my big toe especially, so that I can not bend my toe. That has affected my ability to walk normally. I'd appreciate any feedback.

Yup, I've got little to no control over my big toe due to the scar tissue as well. I will say that it has gotten better over time though. Just keep flexing it back and forth manually with your hand or bounce up and down on it slightly while seated. With a little of that I can now bend it maybe 30 degrees or so where with my good foot it goes 45-50 degrees. That's over a month or so of progress where a month ago I couldn't move it at all.