Lisfranc Foot Fracture Stories - part 3

OK, well, I hope I am doing the right thing. I've decided not to have surgery. I realize I am taking a chance but from the sounds of it my injury is not as bad as a lot of the posters here. I feel for you guys cuz I am miserable at this point, I can just imagine what everyone else with worse injuries have gone through.

After thinking about it "as close to normal" as he can is not good enough for me. Not when I'll be on crutches for 10-12 weeks. If he had said... you definitely need it then maybe I would have. But I just feel like having sugery would be opening a pandora's box in my foot.

Years down the road I'll probably regret not trying to fix it but I'll deal with it then I guess.

Hope everyone is up and running (or gettin closer to it :-) )

hi all
I injured my foot on the 12th june 2008 after a fourwheel drive vehicle kindly ran over it, the docs kept me in hospital for nearly two weeks and then operated with screws and k wires, i was put on non weight bearing for 3 months then weight bearing as tolerated, the kwires were removed, 2months post op, and from then was taken out of the hard cast and placed in a fixed boot for 3 weeks, after which i was given a walking boot and allowed to strat weight bearing, which was going really well, i was able to walk without any crutches but very slowly for short distances, and with one crutch for further. with no pain my foot is just stiff, and wont roll from heel to toe. so i cannot run at all, i only used this boot for a week before changing to a normal walking/ hiking trainer type shoe. yeasterday the docs removed the screws from my foot and now it has swollen up badly again, and is very sore around the stitches but iam still weight bearing as tolerated, and only bandaged in the boot which i can discard once my foot fits back into the shoe again. at the moment iam very pleased with my recovery and am hoping iam not going to have any long term problems, but time will tell. i havnt had any physio and have got my foot moving quite well till yeasterday, but at least it isnt as swollen and painful as when they first operated, so heres hoping that within a week or so ill be walking as good as before they removed the screws.

Glad you are doing well. I still have no pain and my cast comes off hopefully for good in 5 days. That will make one month non-weight bearing. I'm hoping the doc will just let me go back to the boot (and hopefully let me walk on it). I got a message on another forum from a podiatrist who said my injury sounded really minor and that I shouldn't have any problems if I go with a good orthotic after. I'm not a high-heel-fancy-shoe kind of person so that doesn't really bother me. It's been absolute hell trying to take care of two kids by myself on one foot though. And they're getting pretty anxious to have mom back the way she used to be. I really don't think it will be that long. I'm finally starting to feel good about my decision not to have surgery.

Hope everyone is well :-)

Here's my story...
Missed a step on the eve of 10/10/08. Excruitiating pain in my foot; at first I thought it was my ankle as it began to swell immediatly. I waited about 15 minutes and poked around on the swelling at my ankle and knew it was ok (multiple previous ankle injuries - I know ankle injury when I see it) so I tried to take a step on it and heard distinct pop as I rolled from the heel to my toes. BAM! Down I went to the ground with horrific pain! Within 30 minutes I noticed that I had 3 egg shaped (sliced in half long ways) bulges on my foot. 1 each at the base of my 1st and 4th toes and one on my mid foot just south of where my leg bone intersects; my ankle was still somewhat swollen, but now pain from there. Decided to go to hospital. ER took Xrays (non load bearing) and said I had a bad sprain, but to follow up with OS the following weak. Walked out on crutches and foot wrapped in ace bandages. Saw OS on Thursday and he examined ER xrays, then lifted my foot which revealed a purplish black bruise all the way across the bottom of my foot from my instep up to my toes. He said I had a LisFranc fracture that needed to be surgically corrected ASAP. He ordered an MRI. Further I had a broken 2nd and 4th metatarsal (hence the egg swelling) . I wanted a second opinion as he told me how rare this diagnosis was. So the following Monday I went to see another OS. He felt my spacing was minimal enough to not have surgery and to just wear a cast, non weight bearing etc. (I also found out that he was no longer doing foot surgery as he was nearing retirement and didn't see need for expensive malpractice insurance) Now I needed a 3rd opinion so I went to see a OS that specialized in feet and ankle injuries. I took my MRI and xrays to him and I didn't say a word. Within 2 minutes of examining me and my films, he diagnosed a Lis Franc Fracture with >3mm separation. Further the MRI showed that I had detached my LisFranc tendon and it was now in between my 1st and 2nd metatarsal, requiring OR to retrieve it from the space and to allow the internal fixation to squeeze the bones together between 1st and 2nd metatarsal. Surgery was 10/24/08 (2 wks.post accident). 2 screws inserted and 3" incision on forefoot for cleaning out scar tissue/tendon. At seven weeks post-op I got cast removed and am now in a short air cast.
My doctor says I can try weight bearing as much as I am able....which is none! I have really tried, but my foot is in far too much pain. My heel is SO sore just to touch as is the pad just beneath my baby toe if I apply even the slightest pressure. My midfoot screams if I just try to apply the smallest amount of weight on it. UGH! Not to mention that my foot has "scaled" (peeled) 2 times in the last 4 days and I am applying moisturizers 2-3 times a day and covering with a cotton sock. What amazes me is that this pain (when I apply weight) feels exactly like it did prior to my surgery. Don't think I am just a wimp...I had both my 9lb. babies with 14hrs of labor and no anesthesia what-so-ever.
We have a pool (which I have considered heating irregardless of the gas bill) to see if it would help to try and walk in it, but after reading some of these posts saying that PT can be damaging if done too soon, I don't know if I should try it. My calf is 2" smaller than my other and I don't know how strong my muscle is now it has deteriorated. UGH! I am so frustrated, mad, sad etc. etc. etc. At least I have company though.

Ok, well, back from the doctor (again). Took another set of x-rays which still show no shifting so I guess that's a good sign. I'm still non-weight bearing until another follow up on the 22nd (MORE x-rays that day). According to what the doc today read to me from the podiatrist's notes, if I understood it right, I think I'll be able to start putting weight on it then? That will be six weeks post-injury. I got him to take off the cast. It was way too uncomfortable in that it was rubbing/ weighing down on other spots on my foot and ankle. It sounds weird but I feel a lot more secure in the boot. I've had a couple falls and close calls with the cast on that felt like it wouldn't have been as bad if I had had the boot on. It was a little weird though. Looking at my x-rays today it almost looked like my first metatarsal was more crooked than it was before. But, the doc said nothing had shifted so I guess I have to take his word for it.

The crack in my third metatarsal looks like it could be getting better? I don't know, it seemed like the line that is the fracture wasn't as black as the x-rays from the night I injured it. I couldn't see the fracture on my second metatarsal. You can only see it using the zoom feature and I didn't want to mess with the doctor's office pc lol. Hopefully I'm on the right track. I'm to wear the boot all the time (as if it were a cast I guess). But for some reason I definitely feel more secure in the boot than the cast. I didn't get a cast until two weeks into my injury so in my mind I guess I was thinking that since by now it seems to be healing I should be ok with the boot. Hopefully I'm right. I plan on being very careful with it so I don't make it worse. Wish me luck. Hope everyone's recoveries are going well.

No, you're not a wimp. It hurts like H**L! (I, too, had babies with no pain control... piece of cake compared to this :-) )And I haven't even had the surgery. I went to the doc yesterday for another follow-up and more x-rays. X-rays (non-weight bearing) still showed no shifting. The fracture on my third metatarsal seems to be getting better. After sixteen days in a cast I had the ortho doc that I'm following up with remove it and now I'm back in the boot. (i'm now 4 1/2 weeks post-injury). The first thing I did was wash my leg/foot and when I was drying it the skin was rolling off like wet paper. Sooo, I've been hitting it really hard with the moisterizer too. I'm using Eucerin Calming Cream. If that doesn't work I just may switch to straight out vaseline.

Morning after hind-sight is telling me I may have made a mistake by having him take the cast off. It's pretty sore today. Or maybe my foot just needs to adjust to being held in a slightly different position? I went the first two weeks after injury with a boot. And the way my mind works I'm thinking that the first couple weeks is when the injury is most vulnerable so I figured going back to the boot now would be no different. I go for another follow up and more x-rays on the 22nd. Hopefully I'll get to start putting weight on it again. The way the ortho doc was smiling/smirking when I asked if he could take the cast off kinda made me feel like I would be ok with the boot.

It's a good thing we've all found this forum or else we'd probably all be going nuts. I don't know about you guys, but my doctors don't really tell me much that makes it easy to make decisions about my treatment.

I have found that Dove Cream Oil really works and doesn't feel oily. No more flaking. Took a few steps in my boot and it is tolerable. I've been doing foot stretches etc. twice a day to get some movement back. Seems to help.

I've only been off it for 4 1/2 weeks and i'm amazed at how much skinnier my leg is. It's kinda creepy. The soreness went away so I think I'm gonna be ok. This may sound crazy, especially this soon after the injury, but I think it was the weather. We had a huge storm yesterday into today and now it feels a lot better. Or I could be imagining it. I've noticed now that the swelling is gone that it's a lot more sensitive. I've read on other posts/threads that the swelling kind of holds things together at first. God, who knows. I've never had something put as much doubt into my head about my body as this stupid foot injury.

Back from my six-week check. More x-rays still showing no shifting. Thankfully, I was given the green light by the orthopedic surgeon to start walking on it. He said that since the displacement was only 2mm, I will most likely do just as well without having had the surgery, which was a huge relief. Of course, he's a guy that does mostly knees and carpal tunnel surgeries, but he's been around a while and I trust him. I'd been doubting my decision since I made it but I finally feel for certain that I did the right thing. I've been walking on it since last night (even did a little shopping). I was a little sore but it was nothing that a little advil couldn't take care of. Just having my mobility back is a huge boost. I go back in 3 weeks now for another set of x-rays to make sure it hasn't shifted with weight-bearing, probably a final x-ray 3 weeks after that. I've been instructed to wear the boot for another six weeks, but I don't care, I'll wear the boot till the fourth of July if it means not being on crutches.

I have just recently found this post, so thanks for all the informative reading. In on 2/7/08 i was involved in a traffic accident when another driver lost control of his suv and came acrossed the highway,in a snow storm, into my lane. I hit the other driver going roughly 50mph. I received 4 broken ribs and had severe foot pain. The xrays revealed no damage to the foot and I was sent home without even a shoe or boot. 3 days later I went to my family physician and he re xrayed my foot. still no findings. 2 weeks later I went back in to the doctor for a follow up. they xrayed my foot again and still said there was nothing wrong with my foot. I was in severe pain and could not put any force on it. 5 days later a radiologist called my doctor and said I needed a cat scan done. it revealed a fracture in my 4th metatarsal, and I was put in a shoe for 4 weeks. returning to the doc he did another xray to check the healing, and decided something did not look right, so he finally refered me to a podiatrist. I had an mri and it revealed 3 breaks in the cuboid bone and a break in the lateral cuneiform bone, as well as a lisfranc fracture. I was put in a boot for 6 weeks, after 6 weeks there was no change, I had a 3mm seperation between the first and second metatarsal. so now surgery is required. I went 13 weeks before surgery. now I am almost 9 months post op. I had 2 screws and 2 pins inserted. I have been told they are now permanent. I still have alot of pain, however my limp is gone, I walk alot slower and uneven surface at times can be unbearable. the podiatrice has told me that the pain I am in is always going to be there, however I will get use to most of it. I am 36 years old and my wife does not understand the limitations I now have. Through my research I have found That the best thing for you is early detection. So for all of you out there I feel for you all. And I wish you the best of luck.

Hi all! I posted here starting in Oct 2006 as I had suffered a Lisfranc injury after a 15foot ladder accident. I had 4 screws and 2 pins, it took about a year before I was somewhat back to normal. I would still walk with a limp if I was on my feet a lot, but I was back to work and weight lifting and 45 minutes of cardio activity a day. Unfortunately the arthritis got to me and the top of my midfoot actually developed a hump in it and I would wake up at night with foot pain and stiffness. The doctor said the only options were live with it or have it fused. After numerous on line searches and reading multiple studies that say fusion is really the best option, I opted for the fusion surgery. I had surgery Oct 3, 2008. If you decide to have any of these surgeries ask your doctor if you can have a pain pump, it is inserted behind your knee into the nerve to your foot and pumps pain meds right to the nerve. The pump lasted me about 48hrs so I couldn't even feel my foot. When its done you just pull it out (no blood) it looks like a tiny fishing line. Anyway after surgery I was in a hard cast for 6 wks and have been in a boot since then. I was non weight bearing for 12wks, partial for 4wks and today full weight bearing (no more crutches). I will start therapy tomorrow. The good thing is I have no more pain, none, I wish I would have had fusion right from the get go, all the studies I have read say that fusion is the best option, but you know how insurance companies are. I know it will take about a year to totally heal but I feel I will be back to normal eventually. So take hope most of you will get better. By the way i'm 52 and already have had a heart attack and by pass. In one year I had heart attack, by pass, lost my father, and the lisfranc injury. So remember their are always people that have it worse than you no matter what the circumstances.

Hi all. I posted here back early 2008, and am hoping some of you lisfranc'ers can give me some feedback regarding failed ORIF, fusion, and cortisone shots or other pain management techniques.

I missed a step back in November 2007 while 6 months pregnant, and suffered a lisfranc injury. I broke 4 bones, but the diastasis was only 2-3 mm, so in view of my pregnancy, we obviously opted to NOT do surgery at that time.

Had the baby in February of 2008, and by June it was obvious the injury was not healing. I had delayed ORIF in August, and had the pins removed in November.

Well, my physical therapy has been totally miserable (painful, and not a "good" painful), so I went back to the doctor. She did more x-rays, and upon reviewing them, frowned and said, "we should have fused it."

She warned me way back that this delayed ORIF was a gamble, but that as young as I am (I'm 35), she thought it was worth a try rather than fusing it right out of the gate. I agreed then, and I still agree, even though it appears to have failed.

So, it looks like the recommendation is going to be fusion. The problem is that I have three children, the oldest of whom is in kindergarten, and the youngest of whom is now only 10 months old. I just can't have this surgery any time soon...probably at the earliest when my son starts first grade in the fall. The doctor said I could put it off as long as my pain would tolerate.

Anybody have failed ORIF and subsequent fusion? Anybody done cortisone shots and have them work for the pain? Any other ideas?

I was involved in a motorcycle crash at the end of aug 08 with my foot getting caught under my bike. A 911 call later and i was off to the local emergency room. I was 100 miles from home but for a small town hospital/clinic the attending Dr had a good clue to what happened ( although all he told me was that it's obviously broken ). They put my foot in a splint and set me up with a ortho appointment after the holiday weekend. I live in a larger city with pro sports teams so my appointment was with the clinic that handles their care...

I was told i had a Lisfranc injury. The discussion that followed was alarming but matches what i have now read in this forum. His description of what we should do started with the history of the injury and normal way of fixation and the complications, his opinion was to go straight to fusion.

Since 3 days had past my foot was really swollen & needed to be put back in a splint and wait for the swelling to go down. My surgery was scheduled & i was instructed to keep my foot elevated. It was hell but i think my wife had the harder job of minding our two kids & attending my needs.

Surgery. i had a difficult time coming out of surgery but they got the pain under control & i was released the next day.

the hardware:


I was put back in a splint for 10 days after which the stitches were removed and put in a hard cast. The surgery pain was finally gone but replaced by the throbbing pain from the blood flow every time i got up from a laying position.

7 weeks in a cast and i was really looking forward to having it removed. After about the 5 week point i could stand on my cast and walked with 1 crutch ( walking on my heel ). The walking boot was a welcome sight but for the first week i felt it was a step backwards as far as pain goes. After the first week i could wear a shoe to drive short distances... i didn't like driving with the boot on.

5 weeks in the boot and i was cleared to start weight bearing using crutches. I was to spend a week or two slowly adding more & more weight until i could shed the crutches all together. i opted for the 1 week plan as i was tired of carrying them around !

i am now 4.5 months along and am still in pain ( Tylenol works fine ). My limp can be gauged by how long i've been on my feet. walking bare foot is a real problem as the orthotic works really well ( once you get used to it ). The insert i was told to get is made by Superfeet. Anyway, it seems i have hit a plateau as i can't detect any progress the last couple of weeks. The problem i'm fighting is walking with as little pain as possible and walking correctly heel to toe.

I am still being told that i have a minimum 9 months before i can stress my foot ( i was asking about getting back out to race my motorcycle ) but 1 year would be better. With having my foot fused they plan on leaving the screws in so won't have the 'normal' second surgery. i'm told the problem with screws breaking or backing out are very rare with fusion.

I was trying to think of any advice that would be helpful but all i can say is... time does pass. the healing process is long but the time till your back on your feet is just a couple of months ( albeit a slower walk ).

best wishes to you all !

tim

Hi everyone, newbie here. My 22 yr old son was injured 16 wks. ago. A 300 pound grate was dropped on top of his foot at work. It was diagnosed as a crush injury at first (3 weeks). Swelling and pain did not go away with rest and ice so the doc ordered a MRI. It showed numerous contusions, a sprain of the Lisfranc ligament, with a 2mm avulsion fracture in the region of the Lisfranc ligament. My son was referred to a podiatrist that has tried everything short of surgery. He was in a hard cast for two weeks but his foot swelled so bad it had to be taken off....then a boot soft cast. 4 weeks of physical therapy. He is now weight bearing, but has pain while walking . Now he is being referred to a surgeon. I'm wondering if it had been too long for surgery to work, or if he really just needs more time to heal. His job requires lots of walking and is very physical. (he has on work comp dis) I think his doctor(and my son) were really hoping it would heal without surgery. The doc. always leaving it up to my son every time he saw him...saying well we can do surgery or we can try to wait and see. I'm worried it had been so long it might be too late to fix it. One more thing, the doc is a work comp doc. Good luck to everyone here, I'm seeing how hard these injuries are to deal with.

I wish I had some good advice for you. The podiatrist I saw was the same way. Wishy-washy, no definite answers. It's frustrating

Right now I'm at 10 weeks post injury. I've been walking on it in the boot for 4 weeks now and so far so good. I'm getting a little soreness but not where the injury was. I was NWB for six weeks and will be in the boot for another 2 weeks. I had my last set of x-rays last week and they still show no shifting of the second metatarsal. So I guess it healed as well as it could have. I see the doc in another 2 weeks at which time he will look at my foot, take me out of the boot and "turn me loose." It's going to feel wierd to wear sneakers on BOTH feet again lol. The podiatrist mentioned that I will definitely need orthotics so I'm wondering where the ortho doc is going to have me get those. Are 0ver-the-counter ones good enough? Guess I'll find out in two weeks.

I've taken a couple steps without the boot and I have no flexibility in my ankle or foot, which I'm sure is just because it has been in the same position for 10 weeks.

Good luck to everyone. We'll all get there eventually! :-)