Lisfranc Foot Fracture Stories - part 3

Hi all.

I'm new to the board, and am now 1 month post-injury and 1 week post-surgery with my LDF (or LFD?). I slipped on the stairs at home and bent the top of my right foot backwards over the stair tread, resulting in dislocation of the 1st and 2nd metatarsals and an avulsion fracture where the ligament has torn off the lateral cuneiform. And some lovely bruises, especially to my toes, which were all bent backwards when I slipped. (A really boring story, so I've been telling people I fell out the hatch of a moving UFO.)

I didn't feel anything snap and the pain was about equivalent to when I'd sprained my left ankle last year, so I assumed it was just a bang and did RICE overnight. The next day it was massively swollen and I could still not put any weight on it at all, so I went to the Minor Injuries unit. They x-rayed, put me in a back slab and referred me to the local fracture clinic.

10 days later, when I saw the orthopaedic surgeon, I'd had time to read up and was able to tell him what the injury was. I'd seen the x-rays only briefly but it was a classic Lisfranc - there was an obvious space in the joint, the fracture was clear as day - and the underside of my foot was one big bruise. I couldn't let him manipulate the foot properly as it was too painful and I'm ticklish, which seems to be a killer combination, but he confirmed my diagnosis and that it needed surgery. They sent me home in an air cast and got me on the table a week after that.

I didn't get to see the surgeon after the op, as it took them nearly 2 hours to get my pain controlled. If he did what he said he would, I now have just 3 screws, and no pins or plates or wires.

I don't have a follow-up now for another 2 weeks, and I'm a bit concerned about the risk of infection as my dressing will then not have been looked at for 3 weeks, and the fact that they didn't put me back in a cast or boot. The area where the incision must be is very hot and itchy and when I'm asleep I can't keep from rolling over so that my foot is underneath me, or stretched out flat, or in some other position where there's pressure on the joint and pulling on the stitches. Then I wake up.

I'm very tired and very fed up. My work contract ended the same day I had the op, so I am now unemployed. I was freshly diagnosed with severe depression before this happened. I just don't know how I'm going to cope.

Reading other people's stories on here has, same as for many others, both cheered and frightened me. I know lots of you have had far, far worse injuries than me and are in worse situations with finances and family responsibilities. I should buck up. But it's also very discouraging to find that so many people are having problems way down the line. I had ORIF and am now wondering if I should have pushed for fusion, but right now there's no way in hell I'm going under the knife again so I suppose I had better just crack on and see how it pans out.

Sorry! A bit rude to vent in my first post but neither my boyfriend nor anyone else round here seems to get that this is any worse than your common-or-garden fractured forearm or collarbone. I don't want to whine at them, but... gah.

Hello everyone.

I injured my foot somewhere around october. I do not even know what I did to it for sure. My doctor diagnosed me first with a first metatarsel break. I had to insist on being off work for a month due to pain and he made me feel like a sissy, although he did accomadate. Upon my next appointment with him he ordered xrays again and said I had a torn lis franc ligament in addition to the first metatarsel break. He recommended surgery. He told me about the tight rope method and recommended that. In december after working on it for a while longer at a labor position requiring standing/walking/lifting for another month I had the suurgery, which was extremely painful afterwards. I was off work for about ten weeks recovering. I was released to work last week and I still have severe pain. My foot feels like it dislocates alot from the pressure of constant walking, and especially when I have any weight I am carrying. I was wondering how people who worked warehouse type jobs that require constant standing/walking/lifting fared after surgery. At this point I do not see how I can keep working with pain of this intensity. I am not a lightweight and have had major injuries before and not felt this much like a sissy. Any one been able to keep a job of this type after injury? anyone had the tightrope done? I feel I am scared to do certain things because I am afraid it will snap if it is stressed too much. Much thanks

Casper

well I will tell my story and hope it helps since I seem to have gone through it ALL and am only 26!! In aug 07 I fell in a hole at a bar immed went to the ER they told me I sprained my ankle even with xrays done 1 week later went to my ortho to find out I had lis franc I had disloacted 4 bones and tore all my ligaments!!! OUCH!!! Got immed surgery 3 days later with 2 pins and 3 screws. Weeks later got the pins removed. Still in severe pain months later he said he was gonna take out the screws so he did Jan 08 only to find out no luck still the same aggitating pain I had all along!!!! So since I knew I had to deal with this pain for the rest of my life I just DEALT with it but just this last winter I couldnt bare any more pain so I went back to the dr only to have immed surgery again to get my foot fused and 4 screws put back in. I am now 6 weeks post-op and still in LOTS of pain which meds seems to be the only relief which my dr doesnt wanna help!!! So I gotta suffer. Not to mention my back is completely messed up now because of this injury it hurts soo bad!!! It is soo hard for me because I have 3 kids ( 6, 3, and 9 mths) So to sit and rest .,............YEAH RIGHT!!!! I am praying that my foot will be ok after this fusion I will you guys updated with what I have to overcome. I since have not worked or have been able to run, jump or even stand for more than 30 min since my fall!!!! I will answer any questions you guys have!!!!

Hi all!
Thanks for your posts and thoughts on this topic! I have read through many of them as I try to decide how to handle my own injury. About 4 weeks ago I tried to save a piano that tipped over when it was being moved and it ended with the piano falling on my foot. I went to the ER and they could see that the 3rd metatarsal had a hairline fracture so they referred me to an OS and told me to stay off it. I went in about a week later and had another set of x-rays done - the doc could see that there was a small gap between the 1st and 2nd metatarsals, but since my foot was so swollen I couldn't put any weight on it to do a good comparison with my good foot. I went in for a third x-ray last week and it was very obvious that the gap was bigger than it should have been and the doc tells me that I have a lisfranc injury. He is recommending that I have surgery (just 1 screw, he says) to help it heal properly, but he said that I can make the decision since it is a gray area.

I am 27 years old, so I don't like the thought of it healing poorly and having to live with that, but my wife is very worried about me going into surgery and, after reading some of the experiences that others have had with recovery, I'm not sure that I want to either. I have been very good about not putting weight on my foot during recovery, and I didn't take any more than extra strength Tylenol for pain during the first few days, so I wonder if the injury is really bad enough to require surgery. I also know that the fracture is healing and that it is better to the surgery now before it heals completely, so I have to make a decision soon... Any thoughts from you all that have been through this?

If the gap is "obvious" it's hard to imagine that the injury doesn't require fixing. The rule of thumb (as far as I can recall - but do check this with your surgeon) is if the gap is 2mm or more -> operate.

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 s***w 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.

:-)

Hey there fellow lisfranc'ers!
I must say I have had a hard time reading about all your injuries as there aren't too many that seem very positive, which freaked me out after I found out what I had done. A mere trip in a tackle while playing soccer I heard something 'crunch' internally. I hobbled off the field on my left heel as it hurt to put weight on the front of my foot and so went for an x-ray the next day. They found nothing and my GP said it just seemed sprained as I had NO bruising and hardly any swelling, so I hobbled home.

Break down of my crappy week:

Sunday - injured foot playing soccer
Monday - xray: told it was just sprained
Wednesday - physio: possible lisfranc, put me in aircast and told to get weight-bearing x-ray
Thursday - MRI: taken before I saw a referred specialist, who confirmed lisfranc injury and said I needed surgery
Friday - orthopaedic surgeon visit
Monday - surgery

I didn't have any fractures or damage to any bones, I believe it was purely the lisfranc ligament. I am now 4 weeks post surgery and I don't really know what to say as all my symptoms, experiences and treatment is different in some ways to many of yours. I only had one s***w put in and was told 6 weeks non weight-bearing, so I've been cruising around on crutches and have 2 weeks to go!!
I have been in NO PAIN at all and took none of my prescribed pain meds as I didn't need them. I do wonder though if anyone was given blood thinners or compression stockings? I was given Clexane (a daily needle to stop blood clotting) and have to wear a compression stocking on my opposite foot the whole time.
10 days after surgery i got my stitches out and cause my doc "trusted me" I only got a backslab cast and bandage which he said I could remove to shower, sleep and massage. I had a numbness mainly between my big toe and second toe which has got better with time and massage, but when I squeeze it gently I still tend to get a pins and needles feeling.
I'm going back to see him next week so hopefully everything is on track. He said the s***w should come out in 6 months and then I will be able to start running again. So fingers crossed everything will go well!
I must say though that being stuck at home after surgery and reading all these horrible stories I got so upset!!! I still get upset :-P but I'm trying to stay positive. I can't wait to start rehab and get back on my own two feet (literally) as I'm sick of being stuck indoors!

Did anyone else have similar experiences with Dr's giving them removable casts and saying to massage their foot?? Also what kinds of things did you do during rehab? I'm told I will be in an aircast for at least 3 weeks after I get off crutches too.
Any hints and tips would be greatly appreciated!! :-)

cheers
em

Hello everyone,
My girlfriend just got lisfranc fusion surgery on August 3rd.
She went to the hospital for special surgery in manhattan to see Dr. David Levine.
He assured us that fusion was the way to go. Even tho it will be a long process it was for the best and she will walk normal again.
She has been blogging about it and is trying to find other people who went through fusion surgery to hear some encouraging results.

If anyone is considering fusion and want to see step by step please check her blog:

http://mylisfrancfusion.blogspot.com/

Hi everybody,

I'm 22 years old and have been going through this lissfranc ordeal for well over two years. I was running after a friend, tripped and rolled my ankle and was taken immediately to the E.R. When I went to the doctor next day, I was told that I'd fractured my foot and would need a walking cast (non weight bearing). I was in the cast for a couple months and eventually moved into a small shoe and weight bearing. After a few weeks, I was released from the shoe, was told I could wear regular shoes again and was prescribed PT a few times a week for about a month. PT hurt tremendously but I was reassured that it was because my injury was fairly new. I didn't think the amount of pain was normal, and returned to my doctor. They kept telling me that I was okay, then eventually they gave me an xray- my foot was in fact still broken, which is why PT hurt so bad (and the reason my foot was red, swollen and I could barely walk on it). They put me back into the walking cast (the big ol' ugly robot boot) for a couple months but my pain didn't ease up. My doctor then suggested that I get surgery on my fracture since it still hadn't healed.
I became frustrated and went for a 2nd opinion. My new doctor took xrays, and within fifteen minutes told me that my foot hadn't fully healed, but my REAL problem was that I had a lisfranc fracture and my original doctor never noticed it. He said I would need surgery on the lisfranc fracture (which was on the right side of my foot), not the left side of my foot (where the "regular" fracture was) like my 1st doctor had said. I couldn't believe that I had almost gotten surgery on the wrong side of my foot! I signed up for surgery and had it in January 2010. I was given a leg block which was painful, but I was sedated within seconds afterwards which was a relief. The doctor put 5 screws into my foot in order to fuse together my metatarsals, which means I would never be a ballerina (haha) but I should be able to regain a lot of normality that I had lost due to my injury. Post-op wasn't as bad as I had expected since I was drugged up the entire time. I eventually went through similar steps as to the "first" time I had been diagnosed with injury; 1) I was put into a plaster cast for a couple months, then eventually moved my way into a walking air cast. I was prescribed PT again, and I felt like it had helped, and eventually went back to regular shoes and tried to go back to normal life. Life wasn't normal, as I realized I still had a lot of pain in my foot (scattered all over depending on the day. It wasn't like it was centralized pain) and called my doctor again. He checked me out, said my xrays indicated my foot was fused completely and there was no way to damage it, and sent me on my way. I have my 1 year follow up in January. So far it has been 9 months and I still feel like my foot isn't 100% better. I used to be a runner and now I find myself cringing at the thought of getting on the treadmill. I tried to run a month ago, and was able to bust out 2 miles but that afternoon (and next day) my foot was incredibly swollen and tender. I don't know if the swelling was due to my foot getting used to exercise and activity once again, or just a sign that I shouldn't be pushing myself so hard. I'm just looking for others that are dealing with my injury right now as I feel lost. Hopefully things will get better for me and I won't be limping around since I'm still so young. :-(

Hello all. I'm 32 and in the Air Force. I broke my 2, 3, and 4th metatarsal in July of 06. My first Dr. put me in a walking cast with crutches. 8 weeks later he had me in regular shoes walking on it and in PT. I was in so much pain I couldn't stand it. I went back to that Dr. and he said there is no way I should be in pain it must be in my head. I requested a second opinion in Jan 07. The new Dr. couldn't belive that I was sneakers and trying to walk around. Turns out my foot was still broken so back came the walking cast and crutches. Finally my foot healed as much as it could. This Dr. told me that when I have problems walking to come back and he would do surgery and fuse the bones and joints and put pins all the way down my toes. I haven't been able to run hardly at all for 4 years now. In the Air Force we do have to run so I no choice but to do what I'm told. After I run I limp around for 2 days. Now recently walking is a challenge. The divet thats on the top of my foot where the bones healed all sorts of wrong is getting more pronounced. Now if I walk for long periods of time my foot swells up and bruises on the top. I have been in a pain level of 3-8 for 5 days now. Its a constant acke of 3 with shooting pains that go up to an 8. I've been taking alive for the pain but that doesn't even seem to touch it now. I have an appt with my base Dr. to try to get back to the Dr. that said that he would do the surgery on my. I'm not so sure that I want the surgery cause the Dr. flat out told me that I would never ever be able to run again not even a little. I'm so stuck on what I should do I almost just want them to cut it off. If anyone has any information that could help me make a decision I would be greatful. And good luck to you all.

I feel for your situation. From dealing with this injury (milder form) for the last two months, I think the best course of action is to find a surgeon that is very experienced with this type of injuries and has a good reputation in this field. Perhaps talk to the other foot and ankle surgeons in the air force. They possibly can help with researching for the best surgeon to go to and explore what is going on with your foot - perhaps there is non-surgical solution as well to look into but the surgeon will know best. As to the running, I am myself a runner and am dealing with a non-dislocated injury but for piece of mind will switch going forward to swimming, hiking and other light impact sports (for the feet) for the next few years to see the foot recovers fully and then will see. I would not risk it with running if possible to avoid, perhaps consider changing jobs if there are opportunities where you do not have to run as part of the job - this is your personal decision that relates to your pain free life and it is best for you to be happy, I think.

On saturday morning I fell out of a window and landed on my right foot. I'm 25 years old and the worst injury I have ever had is a sprained ankle so as soon as I hit the ground I knew I had done some damage. I was taken to hospital and had a x-ray and it showed I had 2-3 fractures but they didn't really explain about it. I was put in a tempory cast and given a appointment for the foot fracture clinic. I attended that appointment today and the first thing the doctor said to me was he believed I may have a Lisfranc fracture because of where I was saying the pain was and from the x-rays he had seen. I was sent down to have a CT Scan and to their credit it was done rather quickly. I came back up to the fracture clinic and had to see a different doctor as mine had been rushed off to surgery. The CT scan showed that I have suffered 4 fractures, He also said something about ligament damage but I was sort of in a daze so couldn't take it in. He advised me that although surgery is possible he would like to put me in a cast for a week with no weigh bearing on my foot and I have to go back next Tuesday for another scan to see if it has began to heal by it's self. I've been told I must also quit smoking to help with the healing process.

LetMeKnowWhenItsOver wrote:

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.

Oh my Gosh I am so there and do not know what to do. I had surgery and got 3 pins, 2 weeks after my fracture and then a cast for 6 more. I am in a boot now and supposed to be starting to walk on it but it hurts so bad and it is still swollen and purply. My calf is much smaller to. I am soooo frustrated too!!!! Expected to be at least hobling now not still unable to walk on it at all!!! How long dose this last and what can help from someone who has been through this already.
Thanks,
Dawn

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