Couldn't find what you looking for?

TRY OUR SEARCH!

just curious what people's experience has been following a lisfranc fusion - i think it would be helpful for people on this board who deal with this gruesome condition. of course there will be bias I would think towards complications and difficulties as why else would one be looking at the board....

please detail if it was an initial fusion or a later fusion after ORIF and how many metatarsal (and which) were dislocated...

also... anybody have the experience or outcome of having an autofusion - that is where the foot fuses itself over time? this is what i am told would happen to mine... although i am worried about the lateral lisfranc join which needs to be mobile but is becoming bothersome...

thanks

Loading...

I am curious about the same thing but I am struggling to find anyone on here that has had fusion done . . .  Please keep me posted if you get any responses.  Thanks!
Reply

Loading...

Have you found any helpful information? I had ORIF for lisfranc injury on October. 31, 2011, but the treatment was late, as the injury was initially misdiagnosed, so it wasn't successful and I'm left with horrible chronic pain and arthritis. My surgeon recommends midfoot fusion at this point, but I'm very hesitant. Any advice from others would be helpful.
Reply

Loading...

Only a few through the forums and some from medical journals. Fusion seems like the best option. I believe that the sooner fusion is done the better. I am anticipating fusion surgery in the next few months and I have been suffering, hoping, for 15 months that my pain would subside and that I could get on with life, but that's not happening. The pain is relentless and debilitating. From what I have read on line fusion gives a better chance of almost-full function (+/- 90% of pre-injury ability). I think that if your doc is suggesting surgery after only 4 1/2 months go for it. Don't waste your time waiting. Fusion has risks too - possible non-fusion, where your body may not fuse the joint even with grafting, or recovery problems - plantar fasciitis, or compartment syndrome, future joint problems in other areas of the foot, etc. It's all a real c**p shoot. But if you could regain 90% ability, instead of what you are capable of now, wouldn't you at least try? That's not to say that everyone that has fusion gets to that ability but it's a hope. I think I responded to you on the other forum but I'm not 100% sure so just so you know, over the past 15 months I have found this forum better than the other one for information, responses, and threads. Take care and let me know what you decide.
Reply

Loading...

Hi All!

I just wanted to add my 2 cents. I had a severe Lisfranc injury with fracture of the 2nd, 3rd, and 4th metatarsals right at the midfoot as well as a fracture of the 5th cuboid on 1/26/11, after sliding in sock feet on our sloped driveway. Foot slid inside sock and folded underneath - toes toward my heel - and I saw the whole thing - sat there on driveway and watched the foot unfold and I said - Oh c**p - you really did it this time! My first broken bones!

About 2 weeks later after swelling went down, I had 1 screw thru #1 & #2 metatarsals to supposedly fix the LIsfranc & then 3 pins to try and stabilize the fractures. The pins backed out on their own and had to be removed 3 months after surgery, and the screw was causing so much pain that it had to be removed 5-6 months after initial surgery. That doc basically botched the surgery! If you want his name...just ask. He does not know how to fix those fractures sufficiently. He is in San Antonio, TX. My comminuted displaced fractures were much too severe and Lisfranc much too severe for such a small surgery.

After screw was removed...over a couple weeks' time my foot started to shift and I had a huge lump on the inside of my foot. Went to a new doctor. He ordered a CT scan and told me that no fractures had healed (after all I had been through nonweightbearing and falling with crutches, etc!!!) and the Lisfranc was a mess, and my whole midfoot was filled with arthritis. Everything was shifting and unstable.

I was referred to a doctor deemed to be the TOP FOOT AND ANKLE SURGEON IN THE WORLD - YES....THE WORLD. His name is Mark Myerson, MD, and he works out of Mercy Hospital in Baltimore. He takes most insurance (if he took mine - he will probably for sure take yours). It is worth the plane ticket. Flew in one morning, preop visit that afternoon, surgery the next morning, back on the plane the next morning. Shuttled around by the hotel people, and I did it all alone. They do make you hire a nurse or an aid or someone to leave the hospital with. They give you a list of agencies to call, and they were all about $20 an hour. I only hired them for 2 hours just to get me out of the hospital and to my room and situated.

On September 13, 2011, so 6 months ago, Dr. Myerson did a midfoot arthrodesis (fusion) with a plate that has 4 screws, plus I have 3 more big screws going through the 1st and 2nd to keep that area held together. The plate screws go through the base of the 2nd and 3rd and through my midfoot itself. I also had about a teaspoon of bone grafted off the top of my heel and put into all of my fractures to help promote healing and fusion. I have about a 4-5 inch vertical scar just left of center on the top of my foot, about a 2 inch scar beside my Achilles tendon where they entered my heel for the graft, and then a couple of screw "cross" cuts on the inside of my foot. That isn't to mention the scars from the first surgery!

For anyone considering arthrodesis (fusion) for a problem such as this, which is what I gather some of you are facing too, I personally think this is the best decision I have made so far. I don't know what my outcome would have been if I had not found Dr. Myerson, but I know my foot was "falling apart." From my midfoot forward, the foot was shifting outward. It was wierd. My friend said as she looked at my feet straight on from sitting in front of me, she said it was like half of my foot was turning out. I couldn't see it as well myself.

Another problem - I was told to take TONS of Advil, Aleve, etc., after I had my first surgery. I must have taken bottles of it for the antiinflammatory effect as well as for pain control. According to Dr. Myerson...YOU SHOULD NOT TAKE THESE NONSTEROIDAL ANTIINFLAMMATORY MEDICATIONS WITH FRACTURES (BREAKS) (i.e., aspirin, ibuprofen, naproxen) (basically, Advil, Motrin, Aleve, etc., etc.). Tylenol is okay. He is extremely generous with the narcotic pain meds because he knows you can't take the over-the-counter stuff, so you don't need to worry about pain. I guess this is a relatively new discovery - that they are finding that ibuprofen and naproxen and other "nonsteroidal antiinflammatory drugs" are PREVENTING BONES FROM HEALING. So if you are on ANY of those - GET OFF OF THEM NOW! If you don't believe me, call Dr. Myerson's office. If you have broken bones now, don't take them!

My internist didn't even know about this new discovery about those over-the-counter meds, so it is probably something that ortho surgeons are finding out first because they are the ones who deal with the bones the most.

Okay - Anyway - Dr. Myerson was also able to remove all of my arthritis in my foot as well. He felt that I would be able to "walk 5 miles again" one day (as if I ever did that before - lol!). The technique that he uses is successful long-term in 93% of patients. I didn't ask him what happens in the other 7%. He did inform me that my previous surgery "just wasn't done properly" and that is one of the reasons my foot didn't heal right. Things just weren't aligned and "fixated" well enough which allowed too much movement. My guess is I was allowed to weightbear much too early as well. Between the ibuprofen and the bad surgery - I was a mess. I had to start over from square one.

With Myerson, I was nonweightbearing for 8 weeks, and then I was in a walking boot for another, I think it was like 43 days. I was then able to come out and go into a good shoe, which I use a good tennis shoe (not a bouncy one...but a firm inner sole...with an arch support inserted that I bought).

Okay - Long story not so short - 6 months after the surgery I am walking around just fine IN SHOES. I will have pain if I am on it TOO long. But just normal everyday stuff - not a huge problem. I have a little pain in my arch here and there off and on - like right at this moment, there is one spot that has a little bit of throbbing pain, but I would say it is like a 2-3 on the pain scale - just annoying. It really varies from day to day and with what I've been doing. I tried to go back to doing hair, but I couldn't handle THAT. Standing for that long on my foot was killer. By the end of my 6-hour days, I was a hurtin' girl. Now I have to do a sit-down job.

I do have a lot of trouble with walking barefoot. It feels like there is a golf ball on the ball of my foot right beneath the big toe. I don't know why. If I rock my foot back and forth on that area, I can feel what feels like tendons shifting across that bone. It is wierd though because the area is no bigger than on the other foot, isn't swollen or anything. It is just ultra sensitive and feels like the bone is bigger. That's the only way I can describe it and I wasn't even injured there. A great deal of the top of my foot is numb, but that came in handy when they took my stitches out - I didn't feel a thing, and they were REALLY embedded in there. You don't notice it unless you touch it though. I have 2 spots that are pretty sensitive if I touch them, but if I leave them alone, they are pretty okay. For a while I wore a gauze pad taped to the top of my foot so my shoe wouldn't irritate that area, but the last couple weeks I've done away with the gauze pads. When I raise my toes up, my 3rd toe lags behind. I have feeling in the 3rd toe when I touch it but I can't make it move. Not a problem - who cares. Doesn't affect anything. Was told this movement "may" come back.

My foot still swells some - very little compared to what it did for several months though (and yes - for months after surgery your foot will turn purple when your foot is down - both surgeries brought that on - doesn't turn purple anymore), and I tend to keep it up at all times (while I am writing this, I have my foot up on a chair). I just tend to think it doesn't swell as much if it is up and it hurts less. It also gets "tense" or "tight". I can't explain it but the whole foot will feel tight sometimes and it will be uncomfortable to try and walk with it tense like that.

Heat definitely helps. If I warm up my foot it is like everything kind of relaxes and feels better. But it is a pain in the butt to always put something on it to warm it up, and of course, it doesn't last.

I had several x-rays for about 3 months because I kept thinking something was "wrong" because of pain and I also fell once, but the last picture taken in December 2011 said everything was healed perfectly. The 4th metatarsal complete fracture was healed so well that they didn't even mention it in the report.

I was told that my hardware will probably not come out unless I have complications. I still limp just a bit, but I think that is more because I lost my insurance (couldn't afford my COBRA payments any longer) and I wasn't able to go to physical therapy, so now I'm so scared of doing anything to hurt it that I am overly careful. However, if I am on a job interview or at a function, I CAN walk without limping. Learned the fist time around in physical therapy that you MUST walk by rolling up over the first metatarsal and onto the big toe or you are not walking properly. Unfortunately, most of us who have this injury end up walking on the outside of the foot. I just read today that that is why they don't put screws in the 4th and 5th when there are fractures. I don't know if that is true or not.

Anyway - I hope this helps. I'm living a pretty normal life. I take hydrocodone with Tylenol once or twice a week just because it makes all the difference in the world if I am going to be on my foot for a longer period of time. If I don't have anything going on that is going to aggravate it, I don't take any medicine.

It rarely hurts if I am completely off of it. In fact, sometimes when I wake up in the morning, I forget that I am not "normal" anymore, and as soon as I step onto the floor, I remember that my life will never be the same :(

However, I do recommend the fusion. I don't think I'd be living the relatively normal life that I am (minus running, hiking, jumping, etc.) if I had not have had it. And overall, I would say the pain is just minimal compared to what I am reading with some people's results.

I think we are stuck with our pain and injuries for the rest of our lives when we have this type. PLEASE CALL DR. MYERSON. It is worth the plane ticket and the 2 nights in the hotel that gives you an amazing discount (across the street). He will also evaluate your MRI/CT/x-rays or whatever and give you a personal phone call and tell you if and what he can do for you. He didn't charge me for doing that. His office staff is the most efficient I have ever worked with. Don't know if you need a referral. You can ask them.

He is hard to get into and I hear it can take months. I kept pressing and kept pressing and kept pressing about needing to get back to my life (I don't have anyone supporting me but myself!) and they ended up getting me in for surgery less than a month after I was told about him. He was amazing. Here is his website:

www.mdmercy.com/footandankle/about_physicians/myerson.html

I hope everyone does well. If you have any info regarding why I feel like I'm walking on a golf ball when I am barefoot but not in shoes... please reply! I sure hope this fusion works. It is 6 months, but every week I think I can see SOME type of improvement - like getting rid of the gauze pads in my shoe. I was told maximum medical improvement can be expected between 6 and 12 months, so I am hoping that a whole lot more improvement happens in the next 6 months.
Reply

Loading...

Forgive if this shows up again but it made me register after I did it and I don't know if it will show up, so luckily I saved it and I will paste it here again:

Hi All!

I just wanted to add my 2 cents. I had a severe Lisfranc injury with fracture of the 2nd, 3rd, and 4th metatarsals right at the midfoot as well as a fracture of the 5th cuboid on 1/26/11, after sliding in sock feet on our sloped driveway. Foot slid inside sock and folded underneath - toes toward my heel - and I saw the whole thing - sat there on driveway and watched the foot unfold and I said - Oh c**p - you really did it this time! My first broken bones!

About 2 weeks later after swelling went down, I had 1 screw thru #1 & #2 metatarsals to supposedly fix the LIsfranc & then 3 pins to try and stabilize the fractures. The pins backed out on their own and had to be removed 3 months after surgery, and the screw was causing so much pain that it had to be removed 5-6 months after initial surgery. That doc basically botched the surgery! If you want his name...just ask. He does not know how to fix those fractures sufficiently. He is in San Antonio, TX. My comminuted displaced fractures were much too severe and Lisfranc much too severe for such a small surgery.

After screw was removed...over a couple weeks' time my foot started to shift and I had a huge lump on the inside of my foot. Went to a new doctor. He ordered a CT scan and told me that no fractures had healed (after all I had been through nonweightbearing and falling with crutches, etc!!!) and the Lisfranc was a mess, and my whole midfoot was filled with arthritis. Everything was shifting and unstable.

I was referred to a doctor deemed to be the TOP FOOT AND ANKLE SURGEON IN THE WORLD - YES....THE WORLD. His name is Mark Myerson, MD, and he works out of Mercy Hospital in Baltimore. He takes most insurance (if he took mine - he will probably for sure take yours). It is worth the plane ticket. Flew in one morning, preop visit that afternoon, surgery the next morning, back on the plane the next morning. Shuttled around by the hotel people, and I did it all alone. They do make you hire a nurse or an aid or someone to leave the hospital with. They give you a list of agencies to call, and they were all about $20 an hour. I only hired them for 2 hours just to get me out of the hospital and to my room and situated.

On September 13, 2011, so 6 months ago, Dr. Myerson did a midfoot arthrodesis (fusion) with a plate that has 4 screws, plus I have 3 more big screws going through the 1st and 2nd to keep that area held together. The plate screws go through the base of the 2nd and 3rd and through my midfoot itself. I also had about a teaspoon of bone grafted off the top of my heel and put into all of my fractures to help promote healing and fusion. I have about a 4-5 inch vertical scar just left of center on the top of my foot, about a 2 inch scar beside my Achilles tendon where they entered my heel for the graft, and then a couple of screw "cross" cuts on the inside of my foot. That isn't to mention the scars from the first surgery!

For anyone considering arthrodesis (fusion) for a problem such as this, which is what I gather some of you are facing too, I personally think this is the best decision I have made so far. I don't know what my outcome would have been if I had not found Dr. Myerson, but I know my foot was "falling apart." From my midfoot forward, the foot was shifting outward. It was wierd. My friend said as she looked at my feet straight on from sitting in front of me, she said it was like half of my foot was turning out. I couldn't see it as well myself.

Another problem - I was told to take TONS of Advil, Aleve, etc., after I had my first surgery. I must have taken bottles of it for the antiinflammatory effect as well as for pain control. According to Dr. Myerson...YOU SHOULD NOT TAKE THESE NONSTEROIDAL ANTIINFLAMMATORY MEDICATIONS WITH FRACTURES (BREAKS) (i.e., aspirin, ibuprofen, naproxen) (basically, Advil, Motrin, Aleve, etc., etc.). Tylenol is okay. He is extremely generous with the narcotic pain meds because he knows you can't take the over-the-counter stuff, so you don't need to worry about pain. I guess this is a relatively new discovery - that they are finding that ibuprofen and naproxen and other "nonsteroidal antiinflammatory drugs" are PREVENTING BONES FROM HEALING. So if you are on ANY of those - GET OFF OF THEM NOW! If you don't believe me, call Dr. Myerson's office. If you have broken bones now, don't take them!

My internist didn't even know about this new discovery about those over-the-counter meds, so it is probably something that ortho surgeons are finding out first because they are the ones who deal with the bones the most.

Okay - Anyway - Dr. Myerson was also able to remove all of my arthritis in my foot as well. He felt that I would be able to "walk 5 miles again" one day (as if I ever did that before - lol!). The technique that he uses is successful long-term in 93% of patients. I didn't ask him what happens in the other 7%. He did inform me that my previous surgery "just wasn't done properly" and that is one of the reasons my foot didn't heal right. Things just weren't aligned and "fixated" well enough which allowed too much movement. My guess is I was allowed to weightbear much too early as well. Between the ibuprofen and the bad surgery - I was a mess. I had to start over from square one.

With Myerson, I was nonweightbearing for 8 weeks, and then I was in a walking boot for another, I think it was like 43 days. I was then able to come out and go into a good shoe, which I use a good tennis shoe (not a bouncy one...but a firm inner sole...with an arch support inserted that I bought).

Okay - Long story not so short - 6 months after the surgery I am walking around just fine IN SHOES. I will have pain if I am on it TOO long. But just normal everyday stuff - not a huge problem. I have a little pain in my arch here and there off and on - like right at this moment, there is one spot that has a little bit of throbbing pain, but I would say it is like a 2-3 on the pain scale - just annoying. It really varies from day to day and with what I've been doing. I tried to go back to doing hair, but I couldn't handle THAT. Standing for that long on my foot was killer. By the end of my 6-hour days, I was a hurtin' girl. Now I have to do a sit-down job.

I do have a lot of trouble with walking barefoot. It feels like there is a golf ball on the ball of my foot right beneath the big toe. I don't know why. If I rock my foot back and forth on that area, I can feel what feels like tendons shifting across that bone. It is wierd though because the area is no bigger than on the other foot, isn't swollen or anything. It is just ultra sensitive and feels like the bone is bigger. That's the only way I can describe it and I wasn't even injured there. A great deal of the top of my foot is numb, but that came in handy when they took my stitches out - I didn't feel a thing, and they were REALLY embedded in there. You don't notice it unless you touch it though. I have 2 spots that are pretty sensitive if I touch them, but if I leave them alone, they are pretty okay. For a while I wore a gauze pad taped to the top of my foot so my shoe wouldn't irritate that area, but the last couple weeks I've done away with the gauze pads. When I raise my toes up, my 3rd toe lags behind. I have feeling in the 3rd toe when I touch it but I can't make it move. Not a problem - who cares. Doesn't affect anything. Was told this movement "may" come back.

My foot still swells some - very little compared to what it did for several months though (and yes - for months after surgery your foot will turn purple when your foot is down - both surgeries brought that on - doesn't turn purple anymore), and I tend to keep it up at all times (while I am writing this, I have my foot up on a chair). I just tend to think it doesn't swell as much if it is up and it hurts less. It also gets "tense" or "tight". I can't explain it but the whole foot will feel tight sometimes and it will be uncomfortable to try and walk with it tense like that.

Heat definitely helps. If I warm up my foot it is like everything kind of relaxes and feels better. But it is a pain in the butt to always put something on it to warm it up, and of course, it doesn't last.

I had several x-rays for about 3 months because I kept thinking something was "wrong" because of pain and I also fell once, but the last picture taken in December 2011 said everything was healed perfectly. The 4th metatarsal complete fracture was healed so well that they didn't even mention it in the report.

I was told that my hardware will probably not come out unless I have complications. I still limp just a bit, but I think that is more because I lost my insurance (couldn't afford my COBRA payments any longer) and I wasn't able to go to physical therapy, so now I'm so scared of doing anything to hurt it that I am overly careful. However, if I am on a job interview or at a function, I CAN walk without limping. Learned the fist time around in physical therapy that you MUST walk by rolling up over the first metatarsal and onto the big toe or you are not walking properly. Unfortunately, most of us who have this injury end up walking on the outside of the foot. I just read today that that is why they don't put screws in the 4th and 5th when there are fractures. I don't know if that is true or not.

Anyway - I hope this helps. I'm living a pretty normal life. I take hydrocodone with Tylenol once or twice a week just because it makes all the difference in the world if I am going to be on my foot for a longer period of time. If I don't have anything going on that is going to aggravate it, I don't take any medicine.

It rarely hurts if I am completely off of it. In fact, sometimes when I wake up in the morning, I forget that I am not "normal" anymore, and as soon as I step onto the floor, I remember that my life will never be the same :(

However, I do recommend the fusion. I don't think I'd be living the relatively normal life that I am (minus running, hiking, jumping, etc.) if I had not have had it. And overall, I would say the pain is just minimal compared to what I am reading with some people's results.

I think we are stuck with our pain and injuries for the rest of our lives when we have this type. PLEASE CALL DR. MYERSON. It is worth the plane ticket and the 2 nights in the hotel that gives you an amazing discount (across the street). He will also evaluate your MRI/CT/x-rays or whatever and give you a personal phone call and tell you if and what he can do for you. He didn't charge me for doing that. His office staff is the most efficient I have ever worked with. Don't know if you need a referral. You can ask them.

He is hard to get into and I hear it can take months. I kept pressing and kept pressing and kept pressing about needing to get back to my life (I don't have anyone supporting me but myself!) and they ended up getting me in for surgery less than a month after I was told about him. He was amazing. Here is his website:

www.mdmercy.com/footandankle/about_physicians/myerson.html

I hope everyone does well. If you have any info regarding why I feel like I'm walking on a golf ball when I am barefoot but not in shoes... please reply! I sure hope this fusion works. It is 6 months, but every week I think I can see SOME type of improvement - like getting rid of the gauze pads in my shoe. I was told maximum medical improvement can be expected between 6 and 12 months, so I am hoping that a whole lot more improvement happens in the next 6 months.
Reply

Loading...

Wondering you your surgery went? I need both feet mid foot fusion and am terrified that things will be worse, or not go well, or that I will limp worse than I am now, and not be able to wear decent looking shoes. I am a 58 year old woman, and am so afraid to do this. I live near Baltimore and saw a good Dr., but still can't make myself schedule it!
Reply

Loading...

I am so anxious to hear how you are doing now! Hopefully, even better. I live near Baltimore and saw that same practice, only saw Dr. Campbell. I am just terrified of doing the surgery. I am a 58 year old woman, a teacher, and in pain almost all the time. I also had a total knee replacement in 2007 and my back is not great, also. Currently, the huge bone spurs and arthritis on the top of both feet hurt a lot, and my left toes are numb, and not sure what that is from. I am so stressed over this... just not sure I can handle all of this. Would love to talk to you!
Reply

Loading...

fancykats1
Just trying to reach out to someone who is currently suffering with lisfranc issues. I am in your age range and just 4 weeks post surgery to have my broken metatarsal pinned. I can't speak to your potential surgery, but just want you to know I'm thinking of you.
Take care.
lisfranchhope
Reply

Loading...

The warning about Iboprufen is really helpful. Thank you so much.

I injured my foot 3 years ago - just dropped a piece of wood on it. X-rays showed no fracture so I was told just to rest it and take pain killers. In excrutiating pain all the time. Went back to doctors again and again and eventually told it was arthritis. Got cross and said "how come one day I can walk and run no problem, then I drop something on my foot and next day have such severe arthritis that I can't walk at all?" They then reluctantly refered me to a 'specialist'. Was given cortizone injections that didn't help at all. Now at last after all this time I have seen a different specialist and it has been diagnosed as a lisfranc injury and I go for fusion surgery next month. I've just got to the point where I'm so glad that I am taken seriously after being fobbed off for so long, and that something is going to be done about it, as I have already wasted three years of my life with this.

Trisha in UK

Reply

Loading...


Hi Trisha, From all I've read, three years might be the record for failing to get a proper diagnosis! Good for you for pointing out the obvious flaw in their thinking. May I say, welcome to the world of non dramatic lisfranc injuries. Mine occurred while watering plants on my deck. I just swiveled and changed my world. Please keep us posted. Em

Reply

Loading...

Does the warning about Ibofrufen and anti-inflammatories also apply to things like Fish Oil, Devil's Claw and Green-lipped Mussel that are supposed to be anti-inflammatory? I have been taking these supplements to try and slow down the development of the arthritis.

Trisha in UK

 

Reply

Loading...


Yes, 'non-dramatic' sums it up exactly! I can't believe how something so simple could change my life so much.

Hope you are doing OK now and back to gardening again.
Reply

Loading...


Hi - agree totally with the need to network with other Lifrancers to share Info, Help, Support and HOPE
this forum is one of the best sources of info
Which is Why I provide a link to Search Steady Health...

BUT There is ONE BETTER option
the LISFRANC FRACTURE CLUB on Facebook
is dedicated to all things Lisfranc
and the speed with which it is growing proves the need for a safe and supportive LISFRANC forum

Keep hooked in to Search Steady Health, BUT Come and Join the CLUB
Lisfrancers and their close friends and family are very welcome
and sharing our stories and experiences helps us all...
Reply

Loading...


Forgot to tell you how to find the LISFRANC FRACTURE CLUB - oops!!
https://www.facebook.com/LisfrancFractureClub OR just search Facebook for Lisfranc Fracture Club
Reply

Loading...