Mid foot fusion after lisfranc injury advice needed

I had midfoot fusion with two plates and bone graft on Jan 11, 2013. I am walking in flat shoes though my foot still swells some and still has some pain. My doctor told me it can be several months before it is completely healed and no pain at all. I do know from prior experience that it takes a while to completely heal because of the complete weight on the foot. I hope you recover quickly.

Hi Beth.

I had an orif for lisfranc dislocation with 2 plates to stabilize. Had my first pt today. Therapist was good. My foot feels tired and tingly. Im scared what my future will become. I am none stop reading these stories that sent me depression.

Hi High Heels, Not to discourage you but I am 2 and a half years and 5 surgeries in and still not healed. This is a debilitating, excruciating, life-altering injury. If you've only had ORIF you may end up needing fusion if arthritis kicks in. If you need fusion it's the same lengthy surgery and recovery time, maybe even longer, if ever... It is hard to be positive about this injury but you have to be thankful for the good things you have in your life. Some days I am just thankful that I can walk at all. Even if it's a pained step, it's a step. Just take this injury one step at a time. Do what your doctor and pt say. Do ALL of the exercises they tell you to do. Don't smoke. Try to avoid anti-inflammatories. Take magnesium. Get good rest. And lastly, listen to your foot. I am very sorry that you are going through this. If you ever have any questions about anything feel free to contact me. I hope your healing goes well.

I am surprised the surgeon refuses to do the surgery at 26 because I had bilateral midfoot fusions at Georgetown when I was 18 (back in 2000/2001) and before the surgery was in the same position described in that I was always in pain. The pain was due to arthritis from over-use (I was a big time athlete and on 6 basketball teams at once and also played soccer, lacrosse, and track). I was very afraid of the surgery and the potential for other parts of the foot compensating as noted in the post but I am 29 have had no problems at all (with the exception of numbness along part of the top in inside of each foot). As long as you take the time to properly recover, do the physical therapy, and maintain current prescription orthotics I would think you would be ok also (though I am not an MD). As noted, you get to a point where you really don't have much of an alternative to the surgery so what is there to lose?

My husband suffered a Lisfranc's injury of 2013, originally diagnosed as a sprained ankle. Eight days later, still in pain, went to a different doctor while on vacation and was re-x-rayed and diagnosed with Lisfranc's injury and put in a cast for non-wt. bearing 6 weeks, then 6 weeks of wt. bearing. After 7 weeks with cast, saw the orthopedic surgeon near our home who put him in a walking boot and gave him an Rx for physical therapy and an appt. for 6 weeks later. He got another opinion just 9 days later and was told the only treatment for Lisfranc's injuries are surgery, either a repair or fusion depending on the MRI results, to be done in a few days. We live in the Phoenix area and want the absolute best surgeon possibly after reading all the scary stories about other patients' experiences. Any suggestions for the best surgeon for the job? My husband is 61 and flips houses and has not remained inactive since his injury inspite of my nagging. I am aware he could have made his injury worse. Please send help! This is already a nightmare!

I'm hoping that this will post, as I couldn't figure out how to actually sign up. Blah. I had a midfoot fusion almost exactly 3 years ago. Two months ago, I couldn't put weight on it again--had it x-rayed--it was broken right above the screws. (I have 5 of them.). I LOVE my surgeon, but when I saw him, he didn't tell me that the screw in my second metatarsal was backing out. My PCP--who is also awesome--told me this a few days later. The hardware needs to come out. I can't right now because my employer will lay me off and likely not rehire me. (Yes--I am looking for new jobs). But my foot hurts. A lot. And I've been in a cam boot for 2 months now. Anyone else have trouble with hardware backing out--and pain related to this?? I feel like o shouldn't be in pain just because a stupid screw is moving. Also--I'm worried because the screw is close to the surface on the top of my foot. It can be seen and felt just by touching the top of my foot--which is really gross. Is there a risk that the blasted thing could come through the top of my foot? That sounds like a pretty terrible thing. Ok. Thanks for any insight you can offer!!

Hi. I recently had a Lisfrac fusion of the first and second metatarsals. There was some other work done due to arthritis - collagen sheets etc. This was my second surgery. My first one was around a year before this one, and was not a fusion. Anyway it failed. After this surgery I had a terrible time tolerating casts. I don't know why - the pain has been well managed, and before and after my previous surgery I was in either a plaster splint or fiberglass cast for at least 8 weeks. I realize living in a cast for 6 weeks isn't easy and can be downright tough at times. I was not totally comfortable with casts after my first surgery - I had bad itching etc - but I went through it without complaint. This time I was put into a fiberglass cast after one week due to itching and other problems. After two weeks I was switched back to a looser plaster splint in hopes it would be more tolerable. It was actually worse - it rubbed against where they had lengthened my Achilles. I could not find a comfortable position at anytime after the Achilles was irritated and after almost 3.5 weeks I was switched to a non weight bearing boot. All I can say is that I am not "soft" - I eagerly awaited this surgery and the chance to be with this surgeon - and have had a great attitude. The best I can describe it is that the casts were bearable but uncomfortable at best, and torture at its worst. I'm much more comfortable now but obviously very concerned with how much this has possibly adversely impacted the outcome of the surgery. Was anyone here who had fusion put into a non weight bearing boot relatively early? If so how were your results? I know the goal of a cast (or boot) is to immobilize the foot and allow union....my foot is definitely more effectively immobilized now than with the last splint. Plus im not constantly trying to wiggle my foot to get it comfortable. I know that the only way to know the outcome is time. But I was just hoping to hear if anyone had success with a boot. Thanks!

Hello! First, thank you all for your honest stories of pain, surgery, more pain, and healing. I too fell (at home) and ended up with a Lis Franc injury 8/10/12; ORIF surgery 8/24/12 - 3 plates and 8 screws. This was a life changing event for me, as I was a surgical assistant, and couldn't return to work. After 4 months off, I lost my job of 9 years. But, God is good and led me to a desk job that I started a week later. I continued having pain on the top of my foot, so my hardware came out on 5/6/13.

Thinking life was going to be grand, I started P.T. Six weeks later, my surgeon released me and I was having new pain in the ball of my foot. Listening to the pain, I saw a podiatrist that I respected, who showed me on my X-ray how my 2nd metatarsal (long bone) had started to die on the end/joint where it met my toe. And, he told my my P.T. did more harm than good, as I was balancing on my toes, causing a lot of pain. Surgery #3 in Sept. 2013 involved an absorbable pin through that area and a rebuilt joint space. Releaf was nearly immediate.

In Feb. of 2014 I started having increased pain again, and my podiatrist suggested fusion surgery. I got another opinion from a 2nd orthopedic surgeon, who gave the same opinion, and I am going in for fusion of the 1st, 2nd, & 3rd metatarsals with bone graft in 2 weeks. The pain has gotten worse over the past month or so, and I am SO hopeful that this will "fix" me this time. I just want so badly to take a long walk with my dog, and not be in pain minutes later. I totally accept that I cannot go back to my prior career, as it would require standing all day. But, I am hoping for the ability to exercise again (gained nearly 50 lbs. in the past 22 months) and lose some of the inactivity weight.

Here are my two cents:  A Lis Franc injury is life changing. Keep listening to your body and not necessarily all of the 'professionals'. Get another opinion when you are still in pain months later. Find support & talk about your pain, or you will quickly become depressed. And, ask for & accept help. You will need it!

Thanks for reading and I wish all readers a pain free future!

Hi. I have had the same injury and it too was misdiagnosed. But I knew better and kept going until I talked my doctor into sending me to a podiatrist. This injury is often misdiagnosed so you can really blame the other doctors for being incompetent. I couldn't even put on a shoe, let alone walk on it at all without a cast or a boot. It was just too unstable. I have never heard about the other joints in the foot giving out after the fusion and that also sounds rather absurd. If you cannot function normally then fusion is the only option and I think that you should do it. I'm a lot older that you so it didn't work out great for me. But it is better than it was. I cN wear a regular shoe at least and it finally feels stable. I wish you luck.

Help and advice required! I had a missed lisfranc injury from a fall 13 years ago. The first and second mets have separated and cause and unstable foot. I am a dancer. My consultant surgeon told me it needs fusion surgery as the injury is so old and there is no other option. Here's what I CAN do - walk around and take long walks and run up and down stairs without too much discomfort - basically do my life. What I CAN'T do is dance for more than 10 minutes without creating pain for a week, run or use the cross trainer in the gym without causing pain. I want to get back to dance and running afterwards. Would you fuse it or leave it alone?

Hello, how did you get on with the surgery. I am a dancer...I have been told fusion is an option too.

Hi Lisa, how are you doing? I am a dancer too and have been offered midfoot fusion for an old lisfranc injury that was missed

So sorry you're dealing with this. My foot injuries (multiple fractures & avulsions and a Lisfranc) necessitated that I have a midfoot fusion. The original surgeon was swithering as to if surgery was necessary but I found a reputable surgeon who specializes in foot & ankle surgery (Dr. Pradeep Alexander he's head of orthopaedics at William Osler one of the teaching hospital groups here is Toronto. His reputation is excellent and I found him to be incredibly concerned and patient orientated) and he said there was no doubt that surgery was necessary. Obviously everyone's injury is different, however, he told me that studies show that if he only pinned it he could guarantee that I'd be "crippled with arthritis within 2 years" and returning to him "debilitated and unable to walk" and at that time he'd have to do a midfoot fusion. His studies have shown better functional outcomes by doing the fusion right away. The injury was in August, fusion surgery Sept 2nd and I only got weight bearing status 6 days ago, so it's no small recovery - I'm trying to tolerate weight bearing now and it's pretty awful.... My understanding is that by having a Lisfranc injury is not good. When my husband had a major surgery a few years ago there were 2 world renowned surgeons and their approaches were very different. One happened to be here in Toronto, the other in Boston, so we flew down to Boston to get a consultation so we could hear the two different rationals. If you track down another foot & ankle specialist who's done lots of Lisfranc surgeries, maybe you could send them your records to get a third opinion. The original surgeon I saw sees about one Lisfranc a year. When I saw Dr. Alexander, he'd seen three that day and does 30 midst fusion surgeries a year. Maybe ask the surgeons about how many Lisfrancs they treat each year and ask them about and long term functional outcome studies.
Good luck with this!
Louise

Why no antiinflammatories?

sorry there is nothing about this post that I do not like, I just simply hit the wrong key