new lisfranc injury/ Do I really need surgery?

Right before Christmas I fell down stairs and broke the lisfanc joint. Luckily I had an emergency room doctor that said although my x-rays looked like no broken bones, he suspected a lisfranc injury and to see an orthopedic surgeon. The cat scans confirmed it. The doctors in the practice did not concur as to whether I needed surgery, or just a non-weight bearing cast, so I went to the top specialist for this type of injury in the area, and he said that if it was his foot, he'd go with the cast only and maybe later on the fusion surgery would be needed. I had a cast for 8 weeks and have now been in physical therapy for 3 weeks. I can now put some weight on my foot, but it is painful and I'm walking with quite a limp. Being 51, maybe I don't heal as quickly. I am using semi-rigid arch supports in a shoe that a shank was put in so that the foot won't bend. My instep is very painful, as well as the top of my foot. I must say though, that I'm still hopeful that the pain will diminish as time goes on. I was an avid hiker and walker, so this is depressing for me.

I injured my foot in July 07. Lisfranc, first & second metatarsal fractures, a completely torn anterior ligament and a bruised bone. I also developed what they called Chronic Regional Pain Syndrome. My foot and leg were cold and discolored and extremely sensitive. I advised the doctor of the symptoms and needed 5 nerve blocks to correct the problem and thankfully they did. However, I am still experiencing pins & needles at times and it is still painful, although much better. I cannot wear a hard shoe. I use orthodics. It was a month after my injury that my doc ordered MRI's and found all of the injuries. At first they thought sprain but after weeks of severe swelling, they woke up. Anyway, I didn't have surgery because of the CRPS, which I was told could get worse with surgery. Since the CRPS was pretty much cleared up I asked the doc about surgery again since I still cannot wear a hard shoe or get a boot on my foot and he said that surgery still might make it worse. The sensitivity levels are extreme with the lisfranc injury and nerve damage even at 6 months later. My doc says I am lucky because he has seen much worse in the healing and life changes with this condition. Being a woman, shoes are a big deal for me, but I guess I should be thankful that I am able to walk at all, right? I suggest that if anyone with this injury has the symptoms I spoke of, advise your doctor right away if they don't see it first. The sooner the nerve damage is attended to, the better. I am still unsure if I should persue surgery thru another doctor ( just so I can wear boots? I love my boots!) you can always find one willing, but is my doctor correct in saying that the surgery might make it worse? I guess it's everyone for themselves on this decision Kimmie. It's been a while since your post...did you have the surgery?

I would be very interested in more details regarding your injury Kimmy. Please contact if possible. thank you.

Ok reading all these posts has made me want to join in the scrum. About me-- 34 year old male. I fell 20 feet off a ladder and suffered a 2mm displacement of the lisfranc joint between the first and sec. medatarsal. Yes my spelling is horrible. I fell and was diagnosed the next day. Had surgery 1 week later( swelling had to come down) with 2 screws inserted. I am presently 3 weeks post surgery in my hard cast. 3 more weeks in the hard cast then I go to the "robo boot". My question to you all is how long was it before you all were walking normal. I need to go back to work, but have to be walking normal since I'm an airline pilot. Also when did most of you resume normal exercise-- running, jumping, basketball, ect... Thanx guys

My 16 year old daughter injured her foot in May while long jumping. The initial diagnoses was a deep bruise. After several weeks and little improvement we took her to a specialist that diagnosed the problem as a Lisfranc injury. We were then informed of the severity of these injuries and the potential that this could bring an end to her athletics (track and volleyball). She immediately broke down and I stood there stunned.

I immediately began educating myself on the injury. The deeper I dig the more depressing the situation becomes. My daughter is scheduled to have surgery Friday (7/25/08). Three screws will be placed in her foot for 6 weeks. We've been told that the recovery will take 6 months, much of which she will not be able to place any weight on this foot.

Has anyone had a full recovery from this injury? Or at least been able to continue an active athletic lifestyle? My daughters life revolves around athletics, I'm extremely concerned that she will be crushed if this part of her life is taken from her.

Any advice or hope?
Thank you.

Hi mickriley. I really feel for your daughter. i am 20 years old and my whole life has revolved around sport since i hvae been 6. i have recently been diagnosed with lisfranc injury and feel pretty down in the dumps.

Goodluck to you both and hope the surgery goes well.

It was a year in July 08 since I injured my foot. I did not have surgery since the doc took so long to discover the extent of the injury and with the crps (which I discovered) he said I might be worse off with surgery. I cannot be worse off. I hit the top of both of my feet with a chair rail 13 days ago. No problem with the uninjured foot at all. The injured foot swelled and bruised up into my toes and is still sore. So, I tend to think that the doc was right and did get a second opinion for no surgery. Saw the pain management doc yesterday (who did the nerve blocks to correct the coldness and discoloration which was causing me to lose bone mass in my foot) who said this will happen with the crps. Wonderful! Something to look forward to. I had to leave my job in Nov because my boss was harassing me. He didn't believe the pain I was in and how his actions (bullying) were causing extreme pain and even went as far as hitting and stepping on my foot. ( I think he was trying to test me.) I guess I failed the test cause I walked out the door. I dedicated 11 years of my life to that job. I liked my job, but he was a bully...fought me on unemployement and is now trying to fight the temporary disability..Thank You for that X-Boss! ..anyway....I went back to work after the initial injury..on crutches for 3 months. Thought I was doing the right thing by pushing myself to go to work. My job was affecting my healing. The pain guy now has prescribed cymbalta which he said will help with anxiety, depression, and the crps.

I still have not tried running, too sensitive. I can't even excer- walk without calculating my every step or without pain. I was getting better on stairs but since I hurt my foot again, that is tough again. It's the going down the stairs without the normal bend of the foot that is difficult along with the sensitivity of landing on it. Still have a problem with shoes and with putting my foot up on a hard surface. I sleep on my side and have to put a pillow between my legs down to my feet because just the touch of my other foot lying on it hurts. I don't want to sound like Debbie downer, but when the doc said this could ruin my life or get better... so far, I have come to see the latter. But I really didn't start feeling a lot lesser pain until May of this year so I am hoping that it will, at least, improve a little more. Unfortunately, it has changed the quality of my life and affected my financial situation.....the sun will come out...tomorrow...tomorrow javascript:emoticon('8)') Good luck to all!

I jumped off a backstop and felt a pop in my foot. I have a one centemeter gap between the 1st and 2nd metatarsals. The doctor says surgery is a MUST.Even tho 6 days after the injury i was fully capable of walking a mile. I wake up everymorning and feel better and better. I am 17 and dont wanna choose the wrong treatment and be messed up for the rest of my life. I'm scared i might make the wrong choice.

I would get several opinions. I have gotten 3 before I decided to go through with fusion. I nervious as all get out. I've already had the tightrope done, but no relief.

So I was doing capoeira (brazilian martial arts) about two months ago and had a 300lb guy land on my right foot with his heel. My foot swelled up and I couldn't walk on it or wear my shoes (tight fitting pumas) for two days. I thought it was just a bruise or minor sprain so I didn't worry about it. After a week though, the pain was still there. I couldn't rotate on my right foot, walking up and down the stairs hurt, applying pressure to the foot hurt, and I would even get sharp pains in my foot whenever I was riding in a car with someone and they made an abrupt start. So I finally went and saw an orthopedic surgeon. They took an x-ray of my right foot without me bearing any weight on it and the x-ray came back negative, no fracture or break. The doctor said it was probably a neuroma and gave me some anti-inflammatory medicine to take for 14 days. Well the medicine didn't help any with pain and my right foot was still looking a little swollen (bigger than my left foot), so I went back and they gave me a cortisone shot to apparently help with the pain (still thinking it was a neuroma). Well my foot was a little sore from the shot and it seemed to help for about 24 hours but then the pain still came back. I figured it was just taking a little time to heal so I didn't do anything for about 2 weeks but the pain didn' t go away. I went back to my orthopedic surgeon and they told me that they thought it was a lisfranc injury so they scheduled an MRI. About a week later I went and got the MRI (bad scheduling) and after two days, I got a call from the orthopedic surgeon saying that all they can see is a lot of fluids and inflammation. So they diagnosed it as a severe contusion and told me not to do any high impact sports for another week and it should be fine. I didn't understand this, I haven't been doing high impact sports on my foot for two months, what's another week going to do? So I've got 5 days left before my week is over and then I get to go do high impact sports. Just don't understand how a contusion would last this long and why a contusion would cause me to wake up with my foot being sore and cause me not to be able to do some basic activities without being in pain? I hope they are right though and it's just some fluke contusion because I'm always in the gym or playing sports and I definately am not looking forward to the possiblity of surgery.

Just following up on my injury after jumping off backstop. Even though the extent of my injury was severe i was still capable of walking which the doctors said they had never seen someone walk while having this bad of an injury. They decided to take x rays of me standing on it since they had never seen anyone walking with a severe lisfranc fracture. After reviewing my options and studying my x rays (which did not look good). I went ahead and chose surgery. After surgery i spent alotta time in pain and on crutches but that lasted only 2 weeks. Then i was put into a walking cast and i've been walking since then with no pain. I get the cast off in 4 days. With no pain in my foot i am looking forward to getting back to walking in my own two shoes and and staying away from backstops. Only downside...returning to work.

You are right...I am 28, have had the LisFranc for 11 years, was treated three years after with RSD (including lumbar nerve blocks and an epidural). However, my pins for my LisFranc are causing problems and my RSD is back...I HAVE to have the surgery to get the pin out and I am worried--my neurologist said teh chances of the RSD worsening are 90%...but, without taking out the pin, my chances of bone atrophy are certain...so, they are going to give me a series or nerve blocks before and after surgery...so, you are right, the chances of RSD coming back are high...makes me way nervous. but I have no choice at this time...for those of you wondering, my first initial two years after the accident and after the pins were removed and THEN replaced were the best...since that time, I have developed severe arthritis, and RSD...and my life has been more challenging since then...the swelling and color changes and temperature changes have increased...Having a LisFranc fracture severely impacted my life, but then again, every possible complication that they said could happen, DID happen. Arn't we the lucky 0.2% of people who get this D*** thing??

I was diagnosed with a lisfranc injury about six months ago. I was lucky to get an accurate diagnosis quickly and after several x-rays, weight-bearing and non, from many different angles my surgeon decided to try and go the non-surgery route. I had to wear the boot & use crutches (completely non-weight bearing) for six weeks. I made weekly visits to the dr and after about three weeks was advised I could at least begin resting my heel on the ground if I was standing. After 6 weeks on crutches I was able to walk in the boot and sleep with only an ace bandage on. I've now been in physical therapy for over three months and still am not running and am experiencing fairly regular pain. At this point it looks like the joint will need to be fused after all. I certainly appreciate my surgeon trying to be conservative with my treatment however it is frustrating to have to go through all of this twice. It's a difficult injury to deal with and I would recommend getting more than one opinion.

I have an appointment for surgery next week. I have walked on my injury for nine months due to the orthopedic doctor missing the fracture. Also the doctor at the emergency room where I went when I first feel missed it. Finally I went to another ortho. and he x-rayed to find the separation, about 3-4 mm. He suggested a cortisone shot in the cartilege but I am declining that. Seems like a bandaid and could encourage me to use the foot more and further damage it. I went to Duke and found a doctor who has done a lot of these, tewo last week. He says that there is no way to repair it without surgery. He said arthritis will occur over the years without treatment. So....I hate it but I feel I have no option. It still is slightly swollen and hurt to even walk gently. What are your thoughts?

i just found out yesterday i have separted metatorsals 1 and 2 and torn lisfranc and ive been playing football on it for a month now i just got the mri and rothman said i need surgery. my chiropractor doesnt im torn i dont know what to do specially when the injury accoured two weeks after returning from an ACL Miniscus repair last year