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I was in a car accident a year ago and crushed my left foot on the dead pedal in the impact.  I had emergency surgery that night to internally fix my broken and dislocated Lisfranc joint.  After months and months of wheelchairs, walkers, moon boots, physiotherapy and various other therapies I am left with an extremely sore and painful foot and I am not able to walk very well at all.  I am 33 and 128lbs so I am in good shape other than this injury and used to be quite active.  I have been told by my doctors that I will likely always have pain in my foot so I am now contemplating having fusion done.  I am hoping to get responses from other Lisfranc-ers that decided to have fusion done after the ORIF about their pain after the fusion.  I know that the recovery is long but I am wondering if there is anyone that can offer insight about their fusion after a few years?  Was it worth it?  Are you suffering in any other areas of your foot because if the fusion?  Have you had to have any further surgeries?  How is your walking?  Can you wear heels at all? Are you happy you had it done?  Any help is appreciated.

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I just happened onto your post. What I was looking for was someone talking about how long a foot would be sore after a fractured foot and ORIF surgery. I too was an active person. I have a job on a ship at sea. While on the ocean working I would spend 15 to 18 hours a day on my feet. Mine was a comminuted avulsion fracture 5th metatarsal, which happened 6 months ago. The fracture went into the 4th 5th met and cuboid joints. I had surgery on it and I'm still not able to go back to work. My surgeon is going to take the metal out in a couple weeks.... I think!? Walking is getting easier but I can't run yet. Huh!! Maybe I should try to skip again! I haven't done that in a while. My neighbors would think I am going crazy! Follow the yellow brick road?! Follow the yellow brick road!

I'm sorry I can't help you with your problem with your foot. I do know that within the tarsometatarsal joint line, the Lisfranc joints, the joints with the 1st 2nd and 3rd metatarsals and their cuneiforms do not move and flex as much as the 4th 5th met and cuboid joints do. Meaning you might not lose that much motion in your foot with fusion surgery. I would think a big thing also is how much your surgeon would actually have to fuse together. After the joint fusion surgery is done and you're all healed up the joint pain goes away.

Well... I just wanted to say hello and let you know that there is someone else out there with foot problem going on. The thing that helps me most with pain and swelling is ICE.

I hope you come to the right decision with a remedy to your injury.

Maybe you can get some ruby red high heels when you're healed up!
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Awe, I feel so bad for you.....I can't even imagine being on my feet for that long when I was not injured! I hear what you're saying about the movement in the 1st, 2nd, and 3rd metatarsals...that's where my break is, also with a stellated/comminuted or "blown up" cuboid. It just sucks. I am just so nervous to do anyhting else to this foot. I have heard that if the fusion is done that other parts of the foot then become strained and can end up requiring surgery. I don't know...I feel like a crazy person with this pain. I can almost count the number of steps I have "allotted" to each day. Sometimes it's 200, sometimes it's 500....crazy....

Well, I can honestly say that I empathize with you. I really do. This is not a regular "broken leg" or "ankle", this is a severely debilitating, agonizing fracture that seems to never heal. I am 14 months post accident and I am not seeing any improvement since April, that's 9 months ago. I truly hope you heal better than me and that you are able to "skip away". I'd be happy with just being able to comfortably walk to the bank. Keep me posted on your recovery and I sincerely wish you well... take care.
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Hey Mel

Seems that I spend most of my time on the computer trying to figure out what happened with my foot and when and how long it will be before I'm all healed up. So for the heck of it I looked up Lisfranc fractures and dislocations in some medical journals (which I'm sure you have done also). One article I found was written by four doctors. It said with severe dislocations and joint damage that it may be better to perform arthrodesis(fusion) to the joints right after the injury and not try ORIF surgery.

I can't explain the article very well.

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I wish that you had a better doctor taking care of you after your accident. It seems that if he was a competent and caring doctor and your injury was severe enough he/she may have thought about doing the fusion post trauma and spared you the post traumatic arthosis that comes with badly dislocated lisfranc joints.

Your doc may have been right in saying you will have an issue with your foot the rest of your life but that doesn't mean you should live with pain. Especially when the fusion would take care of your foot problems. I'm sure you have a hunderd questions about the fusion surgery and you should ask them and be satisfied with the answers. Finding a GREAT doctor is 100% essential. A doctor that answers everything that he can.

The biggest question is whether you're willing to deal with your foot in it's present condition the rest of your life and the arthritis will only get worse.

Also with the fusion surgery I bet you'd find after recouping and getting your strength back you could get into a pair of stilettos no problem!

I had never heard of a stellated fracture before! It's like a comminuted fracture from a hammer. Sounds painful. Hopefully nothing else happened to you other than your foot injury.

Well.............. stay positive!
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Funny, I've read so many medical journals and reports on this injury also and from what I read it seems like 95% of ORIF patients end up with fusion in the end anyway so I totally agree that I should have just had the fusion done from the beginning. Hindsight is 20/20, right? Having said that though, I had no idea what a Lisfranc fracture was the night of my accident and I was just thankful that I was being taken care of right away. It's when I got home and googled it that I realized just how serious it is. I think I would have chosen fusion if I had the choice... The arthritis is my worst fear, and of course the growing pain with that. I mean, I have serious pain 24/7 as it is so it's impossible for me to comprehend how bad it will really get. It's always the fear of the unknown. I hate that if I have the fusion I will be NWB again for quite some time and have to go through all the physio and c**p again, it's just eating up my life... The stellated fracture was exactly like you said, like a hammer had smashed the cuneiform into corn flake like shards of bone so it will never heal normal. I have found a great Foot and ankle specialist in Toronto that is willing to take me on as a patient and he is very compassionate and explanatory. My original doc was like a robot and had no bedside manner at all. Well, I'm curious to hear about your progress and I will keep you posted on mine as well. Thanks for all of your help. I think this injury is only understood by those who have to deal with it. Thanks again for your kindness...
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I am sorry to hear your having trouble. I suffered a lisfranc injury on Jan 1st 2012. Thankfully I went right to the ER as well and 6 days later had 2 screws placed to secure the joint back in place. I had a 2.5 mm gap between the second and third joint, running lengthwise. I am now in my second week post op, 3 rd post injury and NWB. I have a walker and a knee scooter. Found the knee scooter on Craigslist. Life savers I say. I will return to work as a nail tech tomorrow and work 2-3 days a week for a while. I am concerned that my OS said he will leave my screws in for life. I read all the time they break or back out on their own. I won't know more about this desicion until my follow ups. I would opt for a fusion if I were in your position of lengthy painful months and future months. It may be time to evaluate your option with your surgeon. It's your body and you need to ask the benefits, the cons, the process, and prognosis to make your choice with your OS. I wish you the best. I am just trying to stay sane with wrestless nights in this uncomfortable robo-boot, awake every hour looking for a better sleeping position and the exhaustion of being out of shape, and trying to get around. I have one heck of a strong right leg now afeter 3 weeks of using it solely. Ugh this is a tough injury.
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Hi Peggy, I am so sorry to hear that you have had to endure this awful injury as well. It is a very difficult injury to deal with on many levels. I too had a walker but no knee scooter, just a wheelchair and then later on as I became weight bearing i had the robo-boot and a cane. My joint was completely destroyed and non-existent when I was in the accident. I had 2 screws "installed" but one did back out about 10 months after the surgery so they had to take it out. This was not a painful surgery but it certainly was not pleasant since I was awake and then recovering again for a few weeks. The bone was tender and had to fill in that area. I was doing a lot of physical training at the time so I had to stop with any kind of leg press, or elliptical for a few weeks. To be honest I'm still not walking on the front part of my foot at all. I walk almost all the time on my heel. Due to this, my ankle is very sore and tight and I have to massage it regularly and rotate it. I really hope you have a better recovery than I have had so far, it's been devastating for me. I hope you are ok to work (I would be cautious with having your foot down for extended lengths of time, it may swell, burn and ache immensely), I have not worked since my accident.... Well, we can't change the past right? Just have to keep moving forward. Fusion is looking ever better these days due the the pain but I just hate the thought of going through another year of NWB, physio, learning to walk again, etc. I wish you well and please keep me updated on your recovery. Don't rush it and don't put your foot down. Do everything the Dr.'s say to do and do the physio they tell you to. Aqua therapy helped me too, so you may want to think about that. It felt really good to "walk" in the water when there was no way to out of it. In any case, I sincerely hope you get better and can get back to normal life. Take care.
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Sadmelissa, thank you. I work as a nail tech so I sit. I have a higher stool next to my client to my foot is elevated above my hip while I work. I did take all this week off and have only worked one day post accident but pre surgery. I have always worked part time so it's good my clients are less than 5 hours a day. I did talk to my ortho about working a few hours and they said as long as its up next to me, and elevated when I get home. I will see them next Friday so if working was bad, I will take my items home and work there until its better for the salon. As far as your thoughts on fusion. Everything I read is promising for pain relief. I think if you decide to do this, you may be pleasantly surprised. They say this injury is fairly rare, but I don't read many great stories online. I think that's because the great outcomes patients have no reason to be here looking for help. It's only the newly injured or in recovery, or having problems that post the most. I have ready a few very promising stories and articles about this injury. So just keep doing what you can to stay sane and try to laugh. People dont get how down this can make us feel. And how hard a simple trip to the restroom used to be, is such a chore now. Please keep us all posted on your decision and your outcome, it's so important to hear the full deal, start to finish. So many posts stop after they healed and I have no idea how many are living happliy after lisfranc. I bet it's way more than we think, they just have no need to be online with us. :) Im here if you ever need to talk, vent, or want help looking for info.
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Thanks Peggy, you're a breath of fresh air on this forum. It's true, most success stories are probably un-written here but I still struggle in the medical reports to find true recovery but I like your positivity. I will definitely be sticking on here with updates. I have a surgeon appointment in March to discuss and possibly book for fusion so I will let you know. I have discussed fusion before with the surgeon but he wanted to wait until 18 months post-injury to be sure. I think I will go ahead with it for the pain relief but I am very nervous. I am keeping my fingers crossed for you too with your recovery. Just keep in mind that it will be a long road and you may get frustrated along the way but if you keep your positive mindset you should be able to get through it. Word to the wise - don't even try to put heels on when you become weight bearing. Invest in good solid soled shoes (Naot, Clarks, Rockports, etc.) and custom made orthotics. I have given up on even a kitten heel but have embraced "flats" in order to reduce pain a little.
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Awe thank you Melissa. Ya know I get down, I get overwhelmed looking ahead at the long road, but I go through minute by minute. I relive my fall a lot. It was at a friends house, and I am having to go through their homeowners insurance for medical bills. It's something I need to do and they are very understanding. I would do it for them if there were an issue that made it dangerous for them to be on the property. I am also self employed with clients that have been with me for years, so they are very accommodating. I have read some of the worst lisfranc stories on the Internet. And a few good like I said. I honestly believe those who aren't having any problems or they are so minimal just have no need to go looking for answers or help. They are all good so what could they need. Unlike you and I and several others, we are looking for people who have made it out happily and we come across everyone else like us, looking for good, from their bad experience.. Arthritis? I can live with that, we can and probably would get that somewhere in the body anyway. And as long as we can find a way to manage discomfort or treat pain so we can be laughing then things are good. It could be so much worse. I would rather deal with this than have no leg, or legs, or countless other ways we could have been injured. I do however have a closet full of heels, and I will miss them if I never wear them again, but if I am walking, I will be loving it. :) I'm on Facebook via my name here so if you need to message me there at all, or share injury stories, photos or need support, look me up. Have a great week.
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I'm sure we'll bump into each other on here again but I really appreciate your enlightening views.  I have been stuck in this rut for so long I have lost a lot of hope but hearing you helps a lot.  I agree, fully, that it could have been so much worse, and I thank God every day that I survived my crash and that I do walk at all. It's just hard to accept the pain.  True though, we all end up with something wrong with us, I just didn't think it would be in my early 30's.   Well, I wish you luck in your recovery and if you ever have any questions along the way feel free to ask. Take care.
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Hello Melissa

I spoke to you earlier on this tread. I have a question for you. I think I told you about the plate and screw holding my 5th metatarsal together. I am going to have them removed soon. I was wondering if you where "put under" during the removal of your hardware or if they used just a local and you were actually awake for the procedure. I'm asking because when I had the first surgery my doctor told me, before the surgery, that I would be awake for the whole thing. But I wasn't. They did put me under and I was glad they did cause when I woke up my foot was killing me! I'm sure the removal of the metal won't be as bad as the first operation. Another question... after the hardware removal where you non weight bearing again? My toes and ankle don't work like they used to but I'm awful glad to be able to walk without a cast or crutches. Thanks for any help and I hope you're doing well.

Charlie
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Hi Charlie, My OS just gave me a local and I did feel some strange things when they were taking one screw out. I wouldn't call it horrendous pain but it was very uncomfortable and I did have pangs of sharp pain until it was out. For me, I would have rather been out. I'm not good with blood or hearing what's going on. Not to scare you or anything but I was trembling so badly throughout the whole thing I think I scared the surgeon and nurse! I was weight bearing after the screw removal but not 100%. I tried to stay away from any pressure on the front of my foot for an additional 4-6 weeks. That was my own decision though. My surgeon did not communicate anything about weight bearing but in all honesty, when I saw the size of the screw and compared that to the bone it came out of I could only imagine that it had been compromised by the removal so I took every effort to protect it until it filled back in. It sounds like your injury is more recent than mine. I had the one screw removed at 10 months after the injury because it was backing out and I was feeling the head through my skin, not to mention the risk of it breaking. I still have another screw in there and I feel it as well but it's not backing out so it can stay for now. If I have fusion I assume they will remove it but I don't know exactly. I appreciate your kind words and hope that you're doing well as well but it isn't an easy injury to deal with. Keep me posted on your progress. Take care and get better!
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I had an ORIF of my 4th&5th metatarsal due to lis franc injury from a car accident. It completely failed after one year. My doc did a new procedure for a ligament reconstruction of that joint using graft jacket. I am currently recovering from that but it has definitely been better already vs recovering from the ORIF. Outcomes for the fusion are not good long term. The doc's name is seth Launer DPM in albuquerque.
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Hi, Thanks for your response. I am curious about your second treatment. What is the prognosis for recovery with this "graft jacket". I wonder if this procedure will work long term, also, I wonder if this would work for more severe dislocations. Are you weight bearing at this time? This is very interesting and please keep me updated on your progress. I will certainly be looking into this to see if it would work for me....
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