Lisfranc Foot Fracture Thread PART II

Lisa1234 - Thanks for your experience. Sounds like its too bad I put weight on my foot as per doctors instructions. Sounds like a fusion is in the works for me. I'm now getting cramps in my foot when I walk - I think its from my foot swelling too much.

Plantar Fasciitus - I'm sure I got this and I did ballet exercises which are excellent at developing and working the muscles in the feet.

In ballet there are five basic positions of the feet, numbered one through five. Here is the link because I am unable to copy the pictures in this forum: http://www.pbt.org/kids/positions.html

Ballet Exercises for Plantar Fasciitus - When putting your feet in each of the different 5 positions, hold on to something, go up and down on the balls of your feet. I have written about this in an earlier post on this forum. Anyhow, it really helped me and I know it will help everyone stretch all of the muscles in your feet. Be sure to hold on to something and stand up straight and not lean especially when going up on the balls of your feet otherwise your ankle joint will be in a weakened state.

I just spoke with another woman (family friend) who had an ankle fusion about 6 months ago and she said that she woke up from surgery with no pain (I guess compared with her ankle before). She's still using the walking boot. She was able to confirm that she won't be able to wear fancy shoes anymore and it will take awhile to adjust to the fusion but that she was happy to not be in anymore pain. She said that she spoke with another fellow who had something (I think his ankle) fused and he was back to doing all his activities before he got injured. Her information and the other fellow that she spoke with - both sounded very positive.

I just got all my x-ray and consult reports forwarded to my family doctor for a referral to a foot and ankle specialist. I agree - DEMAND weight-bearing x-rays if you are unable to put weight on your foot for any length of time and don't take no from anyone.

To everyone else - I'll provide you with an update when I have something new to report. Wish me luck that I get in to see and treatment by the speciliast before ski seasons starts. If it takes me awhile to get treatment, I'm going to try rollerblading this summer. Just trying to keep a positive attitude and active!

Cheers all, Kelly

Hi Lisa1234.. Sorry to hear about your injury. I can't believe how these injuries go undiagnosed for so long.. If you are in constant pain when doing simple everyday things, I guess you should contemplate the fusion. A guy across the road from me broke both ankles in a bad car racing accident some 30 years ago.. About 5 years ago he had one of his ankles fused and he said it was the best thing he did as he has absolutely no pain now - he said to me if I get arthritic pain after some years, don't hessitate - he wished he had done it earlier. The ankle joint provides far more range of motion that the lisfranc TMT joint does in your foot. I was told that the TMT fusion shouldn't effect you that much, as your ankle will take up some of the flexability lost from the fusion. Sorry I can't talk from personal experience.

To answer your question - I am 12 weeks post op and am OK now. I have just started to go to gym this week, stationary bike and rowing machine. I have just started to do land based PT for strengthening - have lost so much strength in my calf, ankle etc. Once these areas strengthen up again it will be good. Would be great if there were some direct foot stregthening exercises to do also.

I am walking around without much pain, just little things here and there and a small ache some times when walking long distances 3/4 kms or so non stop - my foot gets tired. Seems to be getting better though - fingers crossed. I assume once the 15 screws and 2 plates come out my foot will feel better. I was told 6-12 months to go good, 12-18 to be very good. Long recovery. Only bad pain I get is when I sit for a while after having walked for a bit and go to get up, the front of my ankle and middle area of my foot really hurts for 10 steps or so until everything loosens up. The other aches are bearable - just annoying.

You really have to find a good OS who specialises in feet to do your surgery and somebody who has done heaps of these types of operations before and who is very familiar with it. My surgeon was a foot reconstructive surgeon and has done a great job at fixing my foot - he is in Australia though.

Best of luck and I hope things continue to improve for everybody. Hope these posts aren't to much of a ramble..

cheers.

cant meet then, no beer involved!! and im in perth visiting folks until the tuesday. will txt soon...

Dear Kelly2006 and Excavator_Foot, thank you so much for your warm replies and encouragement. I am right midway between Australia and Canada, glad to have got to know you, though in rather exceptional circumstances for all of us.

To Excavator Foot:
It looks like your doc has made a brilliant job. The fact you don't feel
much pain, are able to walk quite long distances and experience slow yet constant improvements are positive signs.And since we have to find the positive side, consider you'll end up with great biceps and maybe a different attitude towards life.

So I shouldn't be afraid of a possible fusion, you say. Of course I need to stop this awful continued pain. Following your advice, I'm now in touch with a podiatry at UCLA. He seems to be familiar with fusions and our old Lisfranc lady and willing to have copies of my films forwarded. Yet he warns cuboid fusions are quite difficult, due to the high non-union rate. Good start!

To Kelly:
why still in doubt about a possible fusion? If rates of success are reasonably high for you, don't waste any more time on conservative treatments.
It seems that your physicians chose a conservative approach: though, when everything less fails (1 year is a reasonable testing period according to my own phys.) go for more, i.e. surgery.
Roller is certainly a good suggestion (I used to do ice sk), I guess for stability providen by boot. Tried cycling? You can use either foot toe or tip: it works.

Coming back to Excavator, whether these posts are just ramble or more rests on us.
We are already spreading precious information: consider that our problem is very little known and often overlooked. I guess there is little demand for new techniques, compared to ankle and knee. Can we change it a little bit?
Looking forward to hear from you on this point,

cheers

Guest - I hope your foot is not in too much pain.. I wouldn't say I would not be afraid of having the joint permanently fused, but if you have given your foot the initial recovery the time it deserves, I was told 12 - 18 months to be 'very good', then the only alternative is to have the joint fused, you shouldn't have to live in pain like this everyday. I was told I may get arthritis later on in life and if the pain is too much to bear, I can have the joint fused too.

As I said, my joint is temporarily fused at the moment and I can only comment for the last 1 month since I have been in a shoe walking around. The last 3-4 days it has really lept forward, I was working outside all day for the past 2 days (concreting), yesterday I was walking on the steel reinforcing mesh in my steel capped work boots, no problem. Was walking around the building site (uneven ground) working, no problems - just careful and watching where I was walking. I was pleasently surprised. I am really quite pleased.

I am not sure if knowing this information helps anybody, but I know when I was sitting on the couch in plaster worried I couldn't go back to my normal job I was devistated.. I do not want to go back into the office like a mole out of the sunshine all day because of my foot. I am not out of the woods yet, but all signs seem to be heading in the right direction. Fingers crossed..

As for the ankle and knee, these are very common injuries in the sporting world and in normal life too. Due to the sporting side of things, I guess quite a bit of research has developed better techniques for repairing these injuries. Plus those joints perform quite a range of motion compared to the lisfranc joint of the foot. I guess that is why doctors are quicker to fuse this joint to subside pain because the range of motion is so small. Still the joint is there for a reason so more answers would be good.!

Can any of you that have had a Lisfranc injury in Arizona suggest a good surgeon?

Hello E.F. and thank you for being there. I'm glad to read about your substantial improvements. Welcome back, normal life! Fingers crossed for your recovery.
The Guest you answered to is actually me. I don't what happened with login, maybe I didn't log in at all. Anyway, the point is still to have or not to have...fusion.

I'm always in pain when bearing weight on my left foot, sitting is my ideal condition and norma life belongs to the past. More mole than ever now! Still doctors are cautious due to high-rate of failure when fusing lateral joint (fourth-fifth metatarsal, as on podiatrytoday.com/article/369). So there seems to be no way out, a true bottomles well! I've been warned too of joint degeneration risk, yet process seems to be very slow and might be slower if wearing orthotics.

According to you, one year is fair enough to decide that conservative care has failed. Well, my year has expired and pain worsened notwithstanding PT, cortison, manipulations. If only doctors could stand in our feet.

Hi,
I had a 20oz frozen water bottle come crashing down on my right foot. I had weightbearing xrays 1 day after accident. No fractures, I was told to be NWB for fear of a small fracture that was not shown. So two weeks later pain was worse, so (NWB) nonweightbearing xrays were taken, Pod Dr thought he seen a fracture in the cunieform at the base of my 2 and 3rd metatarsals. However my dr wants a bone scan to either confirm the fracture or not. He states if shows bone activity he is going to treat it with just being NWB, however if it does not show I am either going to (PT)physical therapy to push through pain or pain Dr for fear it could be RSD/CRPS. I don't fear that is the right diagonses regardless of bone scan. Has anyone ever had just a lisfranc sprain, or know somone who has. If so what is the treatment, I feel like if the bone scan is negative I am going to try to push for either a cast or more time NWB. I am in no way going to PT to increase my pain as I read from many things on internet damage to lisfranc area is painful and there is reason for it. I was wondering if bone scan comes back negative should I push for maybe a MRI to see if there is more damage causing the pain. The Dr did note that my foot is still quite swell on the top and bottom of my foot. Along with persistant bruising three weeks later.. Any information or suggestions would be great..


~Krystal

Krystal,

I suggest you request to have a MRI - try for another opinion, if you can. It sounds like with the amount of pain you are having, it should really be checked out to the fullest.

You might read this web article ( hope you can pull it up)
aafp.org/afp/980700ap/burrough.html
It talks about treatment, surgery vs non-surgery.

Good luck & keep us updated

SKH

For those that where interested in how foot fusion goes I am just posting an update.
It has been 4 months since my surgery and about 8 weeks since I have been walking. There is by far much less pain in my foot now then what the first Lisfranc repair provided me last year. There is a learnng period on how to walk with a foot that has been fused. I have had a couple of falls when walking on loose rocks/stones with the fused foot. This is a apart of learning how to walk with the new foot. I am glad I did not wait too long to have the foot fused. I would suggest to anyone that is having bad and constant foot pain, one year or more, after their first Lisfranc repair to consider getting a foot fusion done.

Dear Krystal,
I would also recommend you to take a MRI as soon as possible, as it seems to be more suitable for pure joint injuries (non involving bones). I too has a bad Lisfranc sprain (you can read my history on thread-page 20), gone undiagnosed for months. Your fears are correct and caution would suggest non weight bearing until light is spread, regardless of divergent doctors opinions.
I wish you a quick recovery and look forward to getting good news from you,

Annalisa

Hi,
I got my bone scan results today, they were negative. Has anyone experienced that?? My foot still is bruised and hurts right around the lisfranc joint, but now pain is radiating up my leg, especially around the peroneal tendons on the outer side.. Any ideas or suggestions?? My Dr wants me to try heat/cold baths alternating twice daily for 10days to see if that helps.. I have already decided I don't think that will make a difference.. Trying to decide whether to get a second opinion or not...

~Krystal

Hello Krystal,
unfortunately I've never heard or read of such a remedy applied to Lisfranc, but it is known as a spa treatment (Kneipp bath) to help blood circulation.
If I were you, again, I would rush to a very good foot specialist and get a MRI done!

To Fusion:
thank you for the update. I've been advised to delay fusion as long as possible, as if being in pain were always better than fused. Luckily, you prove it to be wrong. Why so much caution about fusion?

To everyone else reading:
did anyone benefit from orthotics? If so, were improvements immediate or slow in time, as my foot specialist suggests?

Thank you again,

Annalisa

It's been quite sometime since I last posted. Wow, so many new lifranc cases. A quick update on my injury. It's already nine months since my operation (Sep 06). Seen my OS yesterday and going through the xray, he noticed that my 2nd metatarsal still has not fully healed (it's a spiral fracture). He will consider the metal plate and screw removal only between 18 to 24 months after the earlier op, so it's still a long way for me to go. He mentioned that it's normal to leave the screws in for such long period. My next appointment to see the doctor is 4 months. I noted that quite a number of you had the screws removed within a few months.

Though the swelling in the foot has already subsided and back to normal size, I do still experience some slight pain especially when I walk too long but it's bearable.

To all the new comers, don't worry, once you get through the 1st 3 months of non weight bearing, life will be much better after that.

Hi My name is Rae. I had foot surgery 3/28/07! I broke my foot on 3/17/07 Since my surgery I have had no pain just swelling. Tomorrow i will be put in a boot for 8 weeks and will be able to walk and drive. Yippee!!

MY foot surgeon was awesome and still is.

I do know I have a long road ahead but at least I started it and it is not day 1 anymore.

I have pins and a screw. The pins will come out end of May. The screw stays in. He said I did a real bad job of dislocating and breaking the first metarsil. I said thanks that's the only way I do things. LOL

Rae