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Hello There! 

An educated guess tells me that if you're here, then you probably have been diagnosed with or suspect you have a lisfranc injury. Early in my injury (pre-diagnosis) I relied a lot upon these forums to inform myself about my injury. As such, I feel a need to let people know my story.

On 24 September 2012, I fell down three stairs at home. The pain was instant and absolutely excruciating. I have previously sprained my ankle, and the pain was not even comparable. An Ambulance was called, I was administer to lots of IV morphine and then taken off to the Hospital. After waiting 7 hours in triage, however with limited pain, I was taken for an x-ray (which apparently revealed no fractures) and was sent home with a bandaged foot/ankle and crutches. It is probably also important for me to indicate at this point I really couldn't differentiate as to whether the pain was in my foot or my ankle. 

Next comes to usual lisfranc story. After already giving me enough stick about calling the Ambulance for a 'sprained ankle', my family and friends were quick to dismiss my complaints regarding inability to weight bear and the significant amount of pain in my foot and were all telling me to stop being a sook and get up and walk. This was not possible at all for the first 6 days post injury. On the 7th day, I started to put a very minimal amount of weight upon my foot. Over about three weeks I eventually got to a point where I could walk reasonably well on the foot but not without significant pain or a limp. 

After five weeks I finally decided that something was not right and went to visit my GP. He sent me for another x-ray, which again revealed nothing. Being suspicious however, as I was unable to lift myself on my toes, he sent me for a CT scan and a body scan. It was at this point that the body scan revealed three fractures. They were described as occult/acute fractures of the 2nd, 4th and 5th metatarsals. Upon receiving this report, my GP sent me to a local orthopaedic specialist. This specialist, looked at the scans and audibly laughed, commenting on the 'pretty colours used' in the films and proceeded to tell me basically to get over it as it was now 7 weeks post injury and it would just have to get better by itself. 

Neither myself or my GP were happy with that response. I was referred to another specialist, this time, one who specialised in orthopaedic foot and ankle surgery. This specialist, Dr Rod Kuo (Parramatta, Sydney, Australia) immediately suspected a lisfranc injury (taking into account the bone scan and the bruising underneath my foot, which is apparently a dead giveaway for a lisfranc injury) and sent me for an MRI. The MRI (taken around 4 months post injury) subsequently revealed that the fractures of the 2nd and 4th metatarsals had not yet healed and that there was significant injury to the lisfranc ligament. 

Dr Kuo immediately scheduled me for surgery and operated within the week. There were some concerns given that I was 5 months post injury, but still good prospects of success. 

I am now three weeks post ORIF surgery (which involved one screw through my mid-foot with two incisions). 

When I woke up from surgery the pain was fine, however within around one hour the pain (from swelling and my CAM Walker being put on too tight) became agony. I was given morphine twice which eventually calmed me down. Other then that pain, still to today I have not experienced any other significant pain. I spent one night in Hospital and was sent home the next morning. 

The biggest issue for me at the moment is getting around. I am 8-12 weeks non weightbearing, however my next appointment is in 4 weeks (at which point I will be 7 weeks non weight bearing and I hope I can begin weight bearing then). I absolutely hate my crutches. They are extremely painful for me to use. My arms, shoulders, neck, legs, foot (good foot), back, hands all hurt! Badly! It is worth mentioning that I am extremely physically unfit and overweight, which is not of assistance. I have been feeling quite down about the whole thing and it is very hard for me to rely upon others to do things as I have always been fiercely independant. I am trying to stary positive however and get through this by putting it in perspective (I am not permanently disabled). 

In Hospital and the first few days after I was discharged I was taking Voltaren, Endone and Panadol. I hated the way they all made me feel so I tried to get off them as soon as possible. I was high as a kite. At about 5 days post off I was only taking the panadol and voltaren. I am still taking the voltaren as I think it helps alot. I also have to self administer a Clexane injection each morning. This is supposed to continue until I return to the specialist. 

I will keep you updated on how I go. 

I guess what I wanted to get across to anyone who comes across this post is that if you suspect you might have this type of injury, do not ignore it. Yes it is serious and it is painful. Do not let others tell you to get over it. The sooner you get treatment, the better off you will be in the long run. 

Melissa, 23.

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******UPDATE******

Almost two weeks ago now I visited my Specialist for my 7 week appointment.

X-Rays were taken and the Specialist said everything looked nice and straight. I was praying, and hoping, and praying, that he would say I could start weight bearing after that appointment HOWEVER no such luck.

My instructions were to be non-weightbearing for two more weeks, then partial weight bearing for two week before transitioning to full weight bearing in the two weeks leading into my next appointment;

Weeks 1-9 = Non-Weight bearing

Weeks 9-11 = Partial Weight bearing

Weeks 12-14 = Full Weight bearing

During the full weight bearing stage my Specialist has given me the go ahead to transition from my CAM walker to a normal shoe if it is comfortable, and to stop using the crutches if it is comfortable. He also said we would discuss physiotherapy at my next appointment (Week 15).

Please note that apparently my treatment planned is delayed by about three weeks as my lisfranc injury was a delayed diagnosis (surgery five months are original injury), I hope that none of you will have to be non-weightbearing for so long.

On that topic, I feel compelled to let you know of a device that has saved my life....THE KNEE WALKER/SCOOTER! (Google it! and hire it!!) This device, while it looks dorky and people will comment and stare, is absolutely amazing!! My crutches were absolutely killing me and really holding me back from doing so much. When I got the Kneescooter however it pretty much changed my life and I can go anywhere on it! And it is quick....you will be moving quicker than anyone who is walking with you! I have even been interstate to a job interview on it (return flights in one day!) and to a football game! As I said, get one!

I have had no pain in my foot for around three weeks now (I am almost 9 weeks post op ATM) although I'm still taking Voltaran as I think it is probably helping with the swelling. After getting the okay at the 7 week appointment to shower and sleep with my boot off my foot is looking a lot nicer too...no more dry skin. All the brusing is also gone and the scabs have fallen off my scar, and it is now barely visable.

Overall, everything is going pretty good. I will return to the forum after weight bearing for a couple of weeks and let you know how I am going...! :-D

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my surgery was in sept.16, i had fallen and lisfranc surgery was done a few days after the MRI. I have also been diagnosed with gout. I have gone through 12 times of pt.It still hurts like hell. i was only put on Norco for about 50 days 1x per day. I elevated with ice over 6 wks and then a boot for several wks. finally pt. it is very painful and have to begin taking indocin and allopurinal for the gout. there is also probability for neuropathy which i had prior to the fall. I also have lumbar disc pinching the nerves and bulging disc. i HAVE TROUBLE SLEEPING FOR THE PAIN. DOES ANYONE HAVE ANY SIMILAR CIRCUM. AND WHAT DO YOU DO WITH AL OF THIS???? ANY SUGGESTIONS WOULD BE APPRECIATED.
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Hello.

I had 7 fractures & 3 dislocations in my foot including my lisfranc joint.

 

Op was eventually 17 days after accident. It was due to be 3 days after injury, in an excellent Spanish hospital, but swelling was too great. Then 10 days after injury, but NHS in Plymouth, England forgot to do correct paperwork for someone who had been in hospital abroad & I waited 7 hours in a bed next to the operating theatre. One official complaint later (with the support of the ward nurse) they finally operated at the same hospital on day 17. They probably had to re-brake the bones because of the delay, but I never got to see either of my 2 surgeons post op. This failing to see surgeons post op is common in NHS.

 

They put in a bucket load of titanium screws & 2 stainless steel plates as the breaks were a comminuted fracture. I'm glad they fixed the joint & they were excellent at explaining the procedure.

 

8 days post op I was walking again (iWalk), although I noticed my thigh & calf muscles have wasted away massively after of 25 days of not using them.

 

I found out about the iWalk knee external skeleton via the web. Then my surgeon strongly recommended it. Brought for £100 on eBay UK. They are cheaper on eBay USA. Or £160 retail. Buy one asap if you have a lower leg injury. Brilliant.

I've not missed a whole day off work since the operation (self employed farmer) and been driving the tractor & dumper truck, but it's really hard as I keep needing to sleep in afternoon & get dizzy. I won't drive a car & will only get in a 4x4 to get to the loo or my caravan.

 

Pain is interesting, normally only 1-2 out of 10. Broken bone pain is very low, zero to 1. But nerve pain is awkward. It's 1-5 on the upto 10 scale. It's often waking me up at night. Liquid morphine & paracetamol do hit it, but make it impossible for me to concentrate at work. All I can do is watch movies or YouTube or sleep. I even find it hard to read.

 

Office work is so hard with buggered up sleep & morphine & naproxen anti-inflammatory meds. However it's really great that my damaged nerves are growing & healing. I don't think about the knackered ligament, that comes later...

 

Really going to focus on avoiding office work & just supervising others to do things on farm. Spoken to hospital again this week & they have said that I've done really well keeping leg raised at least 80% of time. I sleep with leg 30cm above my heart.

 

I'm going to stay mentally positive & try walking longer distances on the iWalk. I managed 900m on day 10 post operation. You get blisters behind your knee if doing +100m, so make sure you use padding behind the knee. However be careful that you don't cut off some of the blood supply to the leg when you bandage on paddling. I ended up getting light headed & dizzy & slow-mo vision for a day because of this, before I worked out the problem (2 nurses at hospital couldn't work it out...)

 

I've got big problems ahead & getting my calf muscle to grow back will take lots of support from physiotherapy. I'm going to have pain walking again & a limp for a long time. I might need a larger shoe size maybe for a while as foot looks bigger. I might need orthotic insoles.

I'm 45 a farmer & a mountaineer & parent.

 

It's been hell for my partner & it was an important break through after 4 weeks when I carried her the first cup of tea using the iWalk. I still can't cook & even sitting on the toilet is really hard not to weight bear. 

 

No idea how long I won't be weight bearing (currently 2 weeks post op) but I'll discuss this with the consultants next week.

 

Thanks all on this forum for advice & help. It was really good learning before hand that I'll have a limp. I hope I've helped others avoid trouble with thigh & hip pain. The iWalk really helps prevent it.

Bye for now.

EC

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UPDATE on my progress:
6 weeks post injury, and 3.5 weeks post surgery.
I took my air boot off after using it for 9 days and have tried wearing a very stout B2 / B3 ice climbing boot. It's called a Salomon Super Mountain and you can buy ice climbing boots on eBay for less the £100.
It's really boring after 6 weeks of being injured. I'm a farmer & forester so I need to get physical jobs done.
I try to do 2 or 3 hours of physical work a day and then rest with my leg above my heart for as long as possible. I also sleep with my leg high up in the bed. I prop the mattress up with a roll of carpet under it or I put a folded bouldering mat under the mattress.

I have a lot of pain around my toes and doc has given me 20mag amitriptyline for nerve pain, to be taken at night. I think I should be very careful using the ice boot after just 3.5 weeks post surgery. My muscles are coming back really well in my calf and a nurse I saw who does physio said the ankle movement is very good. However it looks as if I need to just keep heal weight bearing for another 2.5 weeks, with maybe odd days of using my ice boot. I tried to ask the hospital about this, but I person on the front desk at the fracture clinic wasn't helpful and told me to ask my questions in 2.5 weeks at my next appointment.

Worst stuff at present is pain in top of foot and around toes. I've been told it's nerve pain. Also this is the 1st week that I've had my positive outlook slip and I've really had to try hard to stay happy about the next period of recovery.
Best stuff is having more independence and being able to drive a manual vehicle. Being able to shuffle around the house and up and down stairs. Not having crutches. Having a bath again.
EC
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