Lisfranc Foot Fracture Thread PART II

Sorry double posted

On 10/11/06 my daughter was backing out of our garage and when she turned the car wheel, I was standing too close and the tire ran over and drug me under the car. At first I thought she had ran over both ankles, however turned out both feet.

My right foot is in a cast and I have fractures of the 2nd, 3rd, and 4th metatarsals. This is not that painful. However, my left foot sustained fractures of my 1st, 2nd and 5th metatarsal with a Lisfranc dislocation of the 1st metatarsal. This is extremely painful.

Closed surgery was performed on my left foot and Kwires were put into my foot to hold things in place. I've been back for rechecks two times now. I cannot put any weight on left foot what so ever (like I could) and can lightly pivot on the heel of my right foot when transfering from bed to wheelchair etc.

From what I've read this is a severe injury that will take some time to recover from. I go back to the doctor on the 22nd of November and he said he may be able to remove the Kwires at that time, that puts me about 6 weeks post op. He said that I will require physical therapy and ideally will eventually be able to walk without a limp.

I am just wondering how long other's recovery has taken and how long the severe pain last. I'm taking Percocet after Hydrocodone making me sick and having to take them to often. The percocet work much better and I do not have to take them nearly as often but I do have to take them within about 6 hours apart. The Kwires is what really seems to be hurting. It's a deep aching pain, with some sharpness at times with throbbing. When they removed my cast to look at the wires yesterday I noticed my foot still looking very deformed (and still somewhat swollen), does this go away?

I asked the doctor if I was being a wimp for still having to take the pain meds but he assured me that this is a very painful severe injury that will take a long time to heal. Any experiences you may have, input or suggestions that might help would be appreciated.

I own my own business and will not be able to work for quite some time, so I've had a lot of time to research this Lisfranc stuff and do not like what I've seen as far as recovery time. I'm 39 by the way and otherwise in great health.

Thanks all,
Sammi
_________________
~Sammi~ :-( :-( [/enc]

I don't mean to be too chatty on this board (hopefully some of the folks that were regulars a while back are still around and will weigh in), but I wanted to say a quick welcome to Sammi -- sorry to hear about your injury!





I was on some morphine and some heavy-duty Oxycontin-like drug while I was in the hospital in Switzerland, and then on Oxycontin leading up to and for about 2 weeks after my ORIF surgery (about 1 month on pain meds total). Actually I started tapering "down the stack" during that 2nd week post-surgery -- Percoset and then Darvocet for a couple of days. I tried to get off the meds pretty quickly after surgery, as they were starting to really mess with my head. I think that I had physical withdrawal symptoms from the Oxycontin: I had one night where I felt like I was going to crawl out of my skin. I didn't have the kwires, which sound miserable.



My foot was swollen and misshapen, with nasty skin discoloration, for months. Now, at going on 6 months post surgery, it's not normal, but *much* better than it was. But for the scars I think most people would think it looks like a normal foot -- but I know that it's not *my* normal foot shape: my middle toe cocks at an odd angle, and I have a minor bunion that I didn't have before. It still swells some when I'm on it much.



Pain-wise now I'm at no pain when I'm not on my foot (this was a relatively new and very welcome development), mild to occasionally moderate pain when I walk, and severe pain if I try to jog or run (i.e., enough that I've just tried once).



Best of luck with your recovery!



--Brad



P.S. for folks who are trying to compare notes, I'm also in my late thirties, and in otherwise good health.

Glad to hear the foot looks relatively normal again. I have picture of my feet in the hospital but do not know how to post them or if we can on here or I'd share them in all their glory. I think what makes it harder for me is that my other foot is broken in 3 places therefore both legs have fiberglass casts just below my knees down.

When I went to the doctor last (2wks ago) they took off the one with the pins in it to make sure it was healing ok. My mother took me to the appt. As soon as the guy took the cast off and told me the doctor would be in soon, I whipped out the ol' lady's electric razor and proceeded to shave that leg. The nurses got so tickled that I thought ahead enough to throw it in my bag. So the doctor waited patiently and gave me time to shave before he came in to look at it!! :)

It has been 4 weeks yesterday since the accident and they operated immediately, so I'm lucky they were able to diagnose and fix it so quickly I guess, compared to others who have waited or the diagnosis and or had to wait for the surgery.

Next appt. Weds before Thanksgiving, I'm hoping to have both casts removed. They are itching me to death. When I am up in my wheelchair too long, they swell alot and I think that is when the pins are really felt because the pressure against the cast. I've tried waiting to take my pain meds until I felt the need for them, but when they start (left foot more) to hurt, by the time the pain med takes affect I am next to tears. So, I've just stayed on a regular schedule with them. Even with the meds their is some discomfort with my left foot and I have trouble getting into a comfortable positition to sleep. I'm driving my husband crazy at night either I'm tossing and turning or when I do sleep the meds knock me out so much that I snore very loudly. Poor guy!!!:( He'd sleep on the couch but he says he needs to be here if I need anything.

Anyway, everyday seems a little better, but when I stay up too long, it sets me back a day or two.

Well, I'm rambling now. So I'll end this.

Thanks again for the encouragment.

Thanks for the links Brad. I think that you may be correct on two things. I am guessing that those whom have had successful lisfranc surgery are out enjoying life and not posting on message boards. I also assume that it does take us average Joe's a little longer to recover than it does the professional athletes.

I guess we just need to keep things in perspective. We don't have cancer and we weren't permanently disabled in a car accident or something of that nature. It is a foot injury and it will heal. We may not be able to do all of the things we previously did (hopefully we can) and we may be in a little pain (hopefully not), but it could certainly be worse.

Dave

p.s. I am in my early 30's and I would like to think fairly athletic.

Hi, I have been reading this forum for some time and am pleased to know that I am not the only one suffering this rare injury.

I twisted my midfoot when coming down from a ladder at home on 10/12 and had ORIF to put in 2 screws and one pin on 10/17. I am experiencing a lot of blood pooling in my foot since week 3 ater surgery and it really scares me a lot. If I stand up for more than 5 minutes, my foot turn purple/swelling. I have to elevate my foot almost all the time to keep the swelling down. I know I have improvement in terms of pain and swelling, compared to one week ago.

Recently I notice my injured foot is very cold after elevation for 2, 3 hours. The cold feeling is probably due to insufficient blood circulation, I guess. I am wondering if anyone experiencing the same as I do? and if elevation for too long could create some medical complications?

I have no compression dressing/stocking with my splint now and it might be the reason why I get a lot of blood pooling. I am going to have an appointment with my doctor next Monday and he will switch me to a fiberglass cast. Can I have compression stockings with the cast or I should ask for a boot instead?

I wish everyone a speedy recovery.

I can vouch for the steadiness of this. The first few days after my surgery, I felt blisters just below the cast line at my toes. I of course couldn't stand the burning so I ruptured them and kept an ointment on it. When I went back to the doctor I asked them about this and they said they were called "Fracture Blisters" and I should have left them alone. Has anyone else had the blisters appear at the Lisfranc site? Just curious.

I had a cluster of huge blisters about 1 1/2 in. in diameter over the break in my toe but not over the lisfranc injury. the nurse said it probably was a fracture blister but i never got a for sure answer. I also had blisters completely covering my ankle and calf area so i'm not sure. from what the nurse said though fracture blisters don't seem uncommon.

MyLeftFoot wrote:

My big focus at this point is whether I'll be able to run again. The ortho doc gave me "less than 50%" odds, but the PTs are more optimistic. Unfortunately I have a big setback looming on the horizon, as I just learned that some knee pain I've been experiencing since the accident is a torn meniscus, and I'll likely have to have some surgery on that.

I'm about 3.5 months post surgery, and about 6 weeks post screw removal (only had one screw). Last week I ran a mile on the treadmill. Today I ran 1.8 miles on the treadmill. I'm not a runner, so for me this is pretty good. I'm relatively pain free as far as my foot goes, though my ankle hurts and may have sustained some damage when I broke my foot. I read about your meniscus - it's a good think you're taking care of that. My doctor said I was compensating for the broken foot for a while, which is why no one paid attention to the ankle situation. Keep on top of your knee, and hang in there - you will be able to run again, but it takes time. I tried waterskiing, which is my hobby, and I could not do it yet -but hey, I can't complain. One of the things that are helping me is using a balance ball, or a disc, to teach myself how to use the entirety of my sole again. As for swelling, my foot still swells if I'm in heels all day, but it's manageable. Just take it slowly.

AuthenticFacade wrote:

thelicguitarist, how are you faring, these days?

I'm doing alright, as good as I can with one good foot. It's been painless for a while now and the doctor gave me the ok to start weight bearing on december 6 so i'm just waiting until then. Sometimes I dance on one foot to pass the time.

Sunday night my left foot the one with pins started hurting right at the site of the pins. Monday it progressively got worse to the point I called and tried to get into the doctor. He was not in unfortunately, so I asked the nurse how much pain med I could take without overdosing. I was in tears and she said if I could make it through the night she'd get me in with the doctor 9 am today. (They would rather me not go to ER). So, I took meds every 4 hours and put ice on my toes trying to numb the pain. Needless to say I made it through the night and to the doctor this a.m. I was still sobbing in pain, so the doctor took the cast off, thinking I may have infection at the pins site. Luckily I did not. He thinks it is the nerve endings waking back up because my big toe jumps and jerks a lot lately also causing pain. Anyway, he had planned on taking out the pins next week. He went ahead and removed them today and xrayed the foot to make sure everything still looked in place. It did. The pins felt like they were slicing the inside of my foot.

I wanted to jump off the table when he took them out, but as soon as they were out it made the world of difference. He put me back in a cast however. Next week I go back again, (6wks) and he is going to take right foot cast off next week and put me in a walking boot. The left will be in a cast for a while longer I assume.

Anyway, I just wanted to check it with everyone. I hope you all are healing well. ~SammiTN~

i suffered a lisfranc dislocation of my left foot 24 years ago playing high school football.The night of the injury i had surgery putting everythig back
together using pins.the pain was managable for the first 10 years.but has gotten increasingly worse over the last 14
I have seen a few doctors, tried special shoes and orthodics.Nothing helps.My most recent doctor suggests a mid-foot fusion.i'm a little nervous about cutting my foot open again,but im leaning towards doing it.
if anyone has any experience with a mid-foot fusion,I'd appreciate any
info i could get,since i'm going in blind. Thanks

Just posting an update on my son's progress. His accident happened 9/1/06, surgeries to repair both feet were on 9/11 and 9/18. 2 pins and 3 screws per foot and 1 pin in his left ankle for a broken tibia. On 10/27, the foot pins were removed and he was put into ortho boots and told he could be weightbearing while wearing them. He started physical therapy 3 weeks ago for gait training and ankle strengthening. It probably helps that he is young (20), but he walks well without crutches at this time, and isn't having any issues with pain. He had alot of pain while in the hospital and was on morphine and percocet, but has not taken anything since he was released. He has a duvet cover on his bed, so most of the time his feet are out from under the covers and doesn't have pressure from sheets on his toes. The toes are sensitive to being bumped, can be very painful, but then again, not all areas of each toe have nerve sensitivity. His feet do swell by the end of the day, but not as excessive as earlier. He has mocs, one size larger, to wear once he can walk w/o boots.
Is not working or going to college at this time, but is hoping to go back to school in the beginning of next year.

Hi all, its been awhile since I posted so here's my update.

I received a set of Barefoot Science Orthotics as I saw on tv and they sounded really interesting. They were being flogged by a man and a woman that normally promote healthy living lifestyles through food and exercise. Anyhow they were talking about these things and they made a lot of sense as to what I am trying to do with my foot so I thought I would give it a go. I've never seen them flog anything before so it added to the product's credibility. Here's the link:

http://www.interwood.com/a/p/barefoot/BarefootLanding.shtml

My assessment is still out about them but I can say after using the level 1 inserts for 1 day, you can really feel them up high in the arch, so I can only imagine what the level 5 inserts will do to your feet. For $111 Cdn dollars, I received 2 3/4-lengths and 1 full-length plus a set of 5-inserts for each insole. Well, I thought I would try the level 5 just so I could give you an update and they are really high. I have really high arches to begin with so you can imagine. I expect what this will do is get all the bones and muscles moving within the foot and break down any inflamation that remains. Of course, that's my own theory and opinion with no studies or validation whatever. How is that for a disclaimer! tee hee

On another topic that I have been trying to research - Vitamin D. My girlfriend just dropped off some literature (10 pages of typed info so I'll have to summarize) that states "anyone that lives north of Los Angeles on the West Coast or Atlantic in the East, you don't get enough UVB from the sun in the winter to make adequate vitamin D. And even in the summar, many people are so concerned about getting too much sun that they always use sun protection, which blocks the UV light that makes vitamin D in your skin. ..... That has put many more people at high risk of vitamin D deficiency. The consequences: Vitamin D deficiency can exacerbate osteoporosis. And it can cause weak or aching muscles and bone pain that's often misdiagnosed as arthritis or fibromyalgia. To make matters worse, many doctors miss a vitamin D deficiency because they order the wrong blood test. It's possible vitamin D deficiency could cause "Type 1 diabetes, multiple sclerosis, congestive heart failure, and some cancers. Preliminary evidence shows that vitamin D may lower blood pressure (the results need to be confirmed.) Many experts now agree that, on average, you need 1,000 IU a day if you're not exposed to sunlight. People should get their vitamin D levels checked in November, because if you're deficient then, you'll be severely deficient at the end of winter. And make sure that your doctor orders a test for 25-hydroxyvitamin D, not 1,25-dihydroxyvitamin D, which is the active form. Your 1,25-dihydroxyvitamin D levels are a thousand-fold less than your 25-hydroxyvitamin D levels. As you become deficient, the body tries to compensate by increasing the kidneys' production of 1,25-dihydroxyvitamin D. So those levels are normal or even elevated. In 50 percent of all assays done worldwide, doctors order 1 1,25-dihydroxyvitamin D assay. I don't have a clue what they do with that information."

The article from OsteoGuard Inc. also gives "Food Sources of Vitamin D:

Food - Serving Size - Vitamin D
Fortified milk-1 cup-90 IU
Fortified non-dairy-1 cup-90 IU
Liver, beef raw-3.5 oz-16 IU
Egg yolk-1 large-25 IU

Fish and shellfish
Halibut (fresh,raw)-3.5 oz-600 IU
Herring (Atlantic, smoked)-3.5 oz-120 IU
Mackerel (Pacific, canned)-3.5 oz-252 IU
Oysters (Atlantic, raw)-3.5 oz-320 IU
Salmon (pink, canned)-3.5 oz-624 IU
Salmon (Chinook, canned)-3.5 oz-324 IU
Salmon (Chum, canned)-3.5 oz-224 IU
Sardines (Pacific, canned)-3.5 oz-332 IU
Sardines (Unspecified in tomato sauce)-3.5 oz-480 IU
Tuna (light, canned) - 3.5 oz-236 IU
Cod liver oil - 1 tbsp - 1360 IU"

"Nurition for Healthy Bones
Total Daily Recommendations

INFANT - Elemental Calcium (Milligrams) - Vitamin D3 IU
Birth to 6 months - 210 - 200 IU
6 months to 1 year - 270 - 200 IU

CHILDREN
1 to 3 years - 500 - 200 IU
4 to 8 years - 800 - 200 IU
9 to 13 years - 1,300 - 200 IU

TEENS
14 to 18 years - 1,300 - 200 IU

ADULT
19 to 30 years - 1,000 - 200 IU
41 to 50 years - 1,000 - 200 IU
51 to 70 years - 1,200 - 400 IU
70+ years - 1,200 - 600 IU

PREGNANCY/LACTATION
Under 19 years - 1,300 - 200 IU
19 to 50 years - 1,000 - 200 IU

OSTEOPOROSIS/OSTEOPENIA - 1,500 - 400 - 800 IU"

Hopefully I typed the above correctly and I know it doesn't look pretty but at least you've got the information!

I'm still doing my ballet exercises on a regular basis, walking around more and more in bare feet and wearing my properly fitted orthotics when I'm out shopping. The fitted orthotics really start to hurt after awhile on the top of my foot so I tend to like to take them off when I get home and wear my sandles. When its really late at night, I walk around in bare feet with socks on and I seem to be fine. My intent is to exercise all the muscles not just one set. And most of all, I keep my foot up as much as possible to help the circulation.

While swimming yesterday, I noticed that my broken foot is looking more and more like it used to (as in ballet point ability). I'm 9 months post injury. And, I'm kind of running (not flat out and not free and easy like you normally would) now and then when I have to keep up with my 3 year old. My 9 year old daughter is yelling at me, look you're running! So, I must be moving fairly quickly, albeit not like I should be, but faster than before.

Good luck everyone and I hope nobody else gets this injury as it takes way too long to recover!

Cheers, Kelly

Hi all, boy am i glad i found this site......
I'm a 26 year old male who just found out he has a Lisfranc injury. I hurt my foot 3 months ago in a company softball game. It was diagnosed as a foot sprain (by two different dr.'s) but it didn't seem to be getting any better so i went for a 3rd opinion.
My Dr. is trying to fit me in for surgery sometime this week seeing that the injury happened 3 months ago. Which reminds me, I've read some things about the longer you wait to fix this problem the worse off it can be in the long run....and it's scaring me to death! I'm a very active person, love to play sports, etc....but the clincher is that I'm in sales so i'm on the road a lot. I'm hoping that since the injury happened at a company picnic they'll be understanding.
It sounds like i have a long road ahead of me in terms of recovery. Thanks to all who have posted - I'll keep you guys updated.
It's nice to know there are others out there!!!!