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I fell at work over three years ago and sustained a lisfranc fracture: 2nd metatasal base fractured in two places, third fractured, fourth fractured, fractured cuboid bone. . .dislocation wasn't too bad so I tried to get by without surgery; no weight bearing for 3 months, then the boot, but I developed post-traumatic arthritis within 6 mnths. And, lower back pain and surgeries, which is another story.

Anyway, 7 screws were put in to fuse the joint, but I had continued pain so my dr. removed the hardware. Now, over 3 years later, I still have significant pain walking, and have developed RSD, which causes extreme pain if the top of my foot is touched.

I started neurontin, but had to stop due to the side effects. My next step is a lumbar sympathetic nerve block, to see if nerve burning might help. Anyone else have an experience like mine? I can't believe a simple fall has had such a devastating effect.

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"I can't believe a simple fall has had such a devastating effect."

Tell me about it. :cry:

Here's my story. I am 55 years old.

In my line of work, sometimes I have to climb up on the roofs of buildings to install, and maintain communications antennas. On July 22, this was my first time on the roof of this building.There were two different levels of the roof, one was about 4 feet lower than the other. On both levels, there was white highly reflective cover, when in combination of a bright sunny day, made it real hard for me to see. I needed to get down to the lower level, but the conditions made it very difficult to properly judge how far down the lower level was. In short, I stepped off the ledge thinking it was about 1 1/2 feet instead of 4. Just a 4 foot ledge.

I came down on my right foot, and although I had felt sharper, more intense pain from banging my shin or stubbing my toe, this was a type of pain that I never felt before. My co-worker (not knowing how bad I was hurt, and admittedly, neither did I) helped me to my feet, and I'm hobbling around on it, waiting for the pain to subside, thinking it's nothing but a bad sprain and such. I limped back to the side of the building, and climbed back down a 30 foot ladder, hobbled about 50 feel to my truck, and drove 70 miles back home. But I'm noticing a searing pain each time I pressed on the accelerator or the brake. (Thank God I didn't have to slam on the brake) I called the wife and told her that was going to the ER before I came home. As luck would have it, the hospital's ER was a construction zone. So I had to drive around and hobble through the main entrance. I just fell in through the front doors, the pain was excruciating. Someone helped me into a wheelchair and rolled me to the ER, where they took X-rays. They found the 2nd metatarsal fractured, but they suspected more damage and referred me to an ortho-surgeon the following day. They sent me home in a boot, with no compression bandage to keep down the swelling.

Since I was injured on the job, I had to jump through the Workman's Comp hoops, and it took me two days to get to see an ortho. They told me to get a CT scan and bring both the films and the radiologist's report right back. Curiosity got the the better of me and I read it while my wife was driving me back to the doctor.

I almost had to roll down the window and throw up.

It said I had a "Divergent Lisfranc fracture-dislocation". The base of my 2nd metatarsal (the longest bone of the arch, or mid-foot) was "comminuted", meaning shattered into many pieces. In addition, there were "avulsion fractures" of the cuneiform and cuboid bones, meaning that ligaments have torn away, taking pieces of bone with them.

The first ortho (referred by my Workman's Comp) didn't cheer me up. He was holding up a foot model and showing me where he was going to "fire a pin" here, and "fire a pin" there, in order to stablize the foot. But he says, "I want you to be aware that you're going to have a bad foot regardless. You're probably are going to feel pain from here on out. How much, will remain to be determined. But this is a very serious injury, a very high energy type of injury that I see from auto-accident victims, parachute jumpers, falling thru ceilings, etc. Don't rule out the possibilty that you'll walk with a limp after I've done all I can do. If the pain gets too unbearable, I might have to do a bone fusion. But right now, I have to get in there and try to reduce the amount of arthritis that will set in." But he says, "it will be a couple of weeks before I can operate until the swelling comes down." But they sent me home without my foot wrapped, and didn't tell me to put my foot up or anything.

Well, something didn't feel right about this ortho, so I called a family friend who is a physician and explained what this ortho wanted to do. He investigated and came back and said that for my injury, I needed a foot and ankle specialist, not someone who just 'dabbles' in it, while doing knee reconstructions and shoulder replacements.

He referred me to a foot/ankle doc who he said specializes in Lisfranc injuries. I got an appointment with him on the day two weeks after the injury. He said he needed a new CT scan because the previous one ordered by the original doc didn't have the all the views, but that he couldn't do surgery anyway because my foot was swollen up like a balloon. He sent me home and told me to come back a week later, and this time they finally wrapped my foot up and told me to keep my foot higher than my heart, and ice it down to bring down the swelling. I go back a week later, and he saw that the swelling had come down enough for him to do surgery the following week.

So, 4 weeks after the injury, I undergo surgery. He put in a plate with 4 screws to line back up the 1st metatarsal. He found the base of the 2nd metatarsal blown into little 'chicklets'. He extracts them all and mixes them together with 2 bone grafts that he takes out of my heel, and packs it into the area where the 2nd metatarsal base used to be. He installs a second plate with 5 more screws, and along with 3 more long screws laterally to create a "scaffold" for the new bone to grow. He then fused the entire Lisfranc joint between the 2 plates. Thank God they put a nerve block behind my knee!

I went back last Thursday (two weeks post-op) to get that splint off and the stitches removed. That's when he showed me those post-op medieval looking x-rays. Most of the pain, except for pretty bad twinging, has gone away, but I still need Vicodin to sleep. They put on a new fiberglass cast, and told me to keep my foot up in air for the next 4 weeks. Whenever I have to get up and hobble to the bathroom on my crutches, or go out to the kitchen to get a drink of water, my foot instantly inflates like a balloon like someone's using a bicycle pump, and turns deep purple. I'll feel a lot better mentally when it stops doing that.

I'll keep posting as it seems from reading others' stories, that this is going to be one long journey.
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Hello & I'm sorry to hear about your situation. I sustained multiple foot fractures and a Lisfranc of 1st & 2nd metatarsal. Original surgeon said he wasn't sure is surgery was needed. Went to a Foot & Ankle surgeon who said if he only pinned it, he'd guarantee I'd be back within 2 years crippled with arthritis and he'd do a fusion then & they're finding it best to do the midst fusion immediately. Just got the OK to begin weight bearing last week and the burning & hypersensitivity about the top of the foot is awful. How quickly did you develop the RSD, as that's what I'm concerned with. How is your treatment going? If you're not getting great advice on RSD Rx, try a medical centre that has a Hand Surgery dept with OTs & physics who are Certified Hand Therapists. RSD is MUCH more common in upper extremity injuries so you need people who know about it and treat it on a regular basis.
Louise


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Heidi, it's been over a year since your post so I hope you receive this. We have very similar injury, I have 10 screws, 2 plates with bone grafts. I am 4 months post up and very frustrated. I am allowed to transition into a shoe as tolerated which isn't much. Unfortunately I don't know how much is too much until that night when I'm in so much pain I can't sleep, takes me 2 days of feeling nauseous and plain crappy to do it again. I'm anxious as I'm due back to work in 2 weeks and don't want a repeat of sleepless nights. How are you now? Any suggestions? What kind of shoe do you wear? Orthodics? Thanks for your reply, sure hope this is all behind you now.
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