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Suzanne, how old were you when you fractured your lisfranc joint? how long until you became arthritic - do you know?

Best wishes, Katie.
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Hi Katie,

I am 45, my symptoms worsened around 5 years ago when pregnant due to relaxin hormone and carrying more weight as baby grew. I think the degeneration happened over time and now it's kicking in so I have ongoing daily pain with walking. Dance and attempts at running worsen symptoms alot. I have always been symptomatic since the fall but got away with low level discomfort and feeling that the foot structure was out of line but did not have a diagnosis to explain as it was a subtle lisfranc injury. I also had complex regional pain syndrome in it which is still present and a possible reason for my surgeon to refuse to fuse my foot due to complications from CRPS, best of luck
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Thanks for replying.
So your foot degenerated really quickly then. This has worried me a lot. I just read of another woman who had a mid foot fusion 35 years ago, and only now has pain from arthritis in adjacent joints. Yet there are others who had it done only 5-7 years ago and their foot is in a terrible state.

I'm very young and worried about long term. Especially as mine is a ligament, so I have nothing holding the foot in place.

Has your foot flattened at all?

Katie
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Hi Katie,

Your injury sounds very similar to mine. How old are you? Are you in the UK - which area? What level of activity or sport do you do? I know consultants for this injury in the UK now and may be able to help you try to find a resolution. If your foot is flattened you can wear custom orthotics. Also try getting support from the lisfranc fracture club on Facebook - very good support. Jo

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Hey Jo

I'm 20 and from the South-West. No sports, and not much activity at the moment as I've been recovering from an illness as late. But, I obviously hope to be pretty active eventually.
I'm going to have an orthotic and physiotherapy.

Is your injury new/old has it been treated, etc?

Thanks - I don't have Facebook, but i'll check out the page anyway.

Katie

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Hi Katie,

My injury is 14 years old, it has not been treated yet with surgery. I am waiting for a new MRI and surgical opinion but I have been told it needs fusing. Are you in pain with walking? When did you do your injury?

Jo
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oh sorry didn't realise I was speaking to the same Jo there.

I wouldn't say pain, just feels achey. Changes all the time. Managed to pinch a nerve at one point I think and had pain for a few days, went away. I have a sensation it's going to 'snap'. I wonder whether that's scar tissue that I'm feeling.
I saw a surgeon but only had a wb x ray. Going to an orthopaedic clinic soon, so might push for an mri, so I know exactly what I've done.

I did it about 1/2- 2 years ago I think. I think it was January 2014.

Katie.
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Oh and why were you told that it needs fusing? Is that because it will become worse if you don't?
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Hi Katie,

I now have pain with walking and worse with exercise. My foot joint is unstable and clicks out of place. There is early arthritis - that's why I am offered fusion but I don't have to do it. Its an option, Jo.
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Has your arch been slightly lower all this time? Mine lowered as soon as I snapped it.

Mine can rock about much more easily, and it droops. The surgeon I saw disagreed that it was unstable. I have had it 'pop' up when I walk, this isn't painful, but an odd sensation. He dismissed this also.

How is yours unstable? How would you describe your past pain and your pain now? What levels and what sort of sensation?

Do you think you'll go for fusion? Do you only have arthritis there? I hope my questions aren't too annoying and you're happy to talk?

Katie.
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Hi Katie,

I have had 4 surgical opinions. They all point to fusion - the joint is more unstable now the injury is older due to the arthritis. I have always had pain - ache, sharp, and nerve pain from CRPS. The MRI and CT scan confirmed degeneration. I am level 3 with pain most of the time - up to 6 with exercise. I have a tremor in the foot and leg when weight goes through the foot - most likely from instability. My injury was missed in the early days even by a surgeon - only when symptoms worsen with time might they notice it differently. However, you need to get someone experienced with lisfranc - and subtle ones too.
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Well, I went to a really experienced surgeon. I don't think he disagreed with the idea it was a lisfranc, just that it's old and I'm not in pain, so recommended conservative treatment.
He said he could do an mri but it would be too expensive (this was a private consultation).
So I'll see what happens at the clinic and if no luck, arrange another consultation with someone else.

I think we must have a very similar injury, he said the gap in my joint was 'larger than normal, but not excessive'. And on the first sets of x-rays which were non-weight bearing there was no obvious gap at all.
Classic lisfranc story!

I just want long-term good foot function, obviously with minimal pain. I gather this is something that's difficult to predict. Some people have terrible outcomes, and like I said, that other woman went non-symptomatic following a fusion for 35 years.

You're much more active than myself, and looks like you plan to stay that way. From what I gathered they don't know whether that accelerates future arthritic problems or not. There doesn't seem to be much long term follow up to these things. Very annoying.

What have you been doing for foot wear? Do you tape at all? I put some tape round my foot and it felt much nicer when walking.

I'd like to know how your fusion recovery goes, when you decide to have it.

Katie.
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Hi Katie,

The last surgeon I met felt that fusion would give me better function than not fusing. However, he left the NHS and I am waiting for his colleagues assessment on the NHS. I have been told by 3 other surgeons it is unstable for sure and have had a steroid injection into the joint which did not work. Sounds like your surgeon is good. However, second opinions can be very helpful. Even 3rd opinions. It may be the case with you that nothing happens for a while and then problems when you're older. Even if I had been diagnosed at 2 years, fusion is the only option left after a certain time frame. Tape did not work with me - but yes I tried it. Orthotics have been the best help in a trainer or clarks shoe. I recommend this clinic if you wish for another private opinion 

***edited by moderator*** web addresses not allowed

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Thanks for those links.

How did they diagnose instability? To me, it seems unstable - I can move it too much and it's caused my arch to flatten! But the surgeon disagreed that this was 'unstable'. Can you go on your tip toes etc?

I realise this is a really bad injury and I'll never have my foot back to normality.

Which orthotics do you wear?
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Hi Katie,

The instability was diagnosed by a manual check of the foot both during x-ray and on the couch. The bone clicks out when moved as compared to the other which does not. I can go on my tip toes yes but I wobble lots on the left but as I am sporty I have good muscle control around the instability. I wear custom orthotics made for me by the london foot clinic with link clinic to my local area. It sounds like you need another opinion. I have learned to live with mine, orthotics are the best thing that help, surgery may happen after my next MRI opinion etc. I have compensation pain and problems - due to instability. My foot has always felt 'broken' since I fell but I have got very used to the feeling even though I don't like it. I knew when I fell from 1 meter onto concrete on that one foot that it was not a great injury to heal up. I knew there would be problems. How did you do your injury?
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