old lisfranc injury, just diagnosed--should I have the surgery?

How are you doing? My son who is 16 and soccer player has a Lisfranc's injury occurred in a soccer game Oct 14 2012 just got the diagnosis correct and have had 2 opinions ortho foot and ankle specialists one says do surgery the other not because it is too late "window of opportunity missed" His is a mild 1 mm dislocation between 1st and 2nd metatarsal he is able to do a lot of movement with out pain, but when he twists a certain way and it has happened more than once it is level 10 pain that takes him down. Would love to hear where you are with this ordeal now, Sally (mother)

Hi Sally. I really feel for your son, and my mom feels for you! When I was going in for the surgery, my mom and I both cried - she told me how hard it had been to see me in pain all those years. My pain was similar - I was fine sometimes, but level 10 pain other times. So awful. I'm now about 21 months out, and I'm so glad I did it. I would say if you trust the surgeon who says to do it, and s/he has done it multiple times before and will do good follow-up with consistent physical therapy (I went for about four months, and my doc gave me the option for more), then go ahead with the surgery. But that's just based on my experience. I hope it works out for your family!

Hi Sally,
I'm so sorry to hear about your son's injury. I did decide to have the surgery once I had the correct diagnosis. My injury was not diagnosed until years after the initial trauma. In fact, I don't even remember when it occurred. (I played soccer in college and am sure it happened one of the times I thought that I sprained my ankle again.) I had two different opinions. Anyhow, I did decide to have the surgery because my quality of life was affected. I couldn't be active and do the things that I love to do...and wasn't okay with changing my lifestyle. I am so happy that I went through with the surgery. While recovery did take awhile, it was totally worth it in the long run. I was back to playing soccer and running without pain after about a year total. I know every circumstance is different, but my experience with the surgery was very positive. Good luck with whatever your son/you decide!

Just curious between which metatarsals your dislocation was and how many mm ? His is 1mm between the 1st and 2nd Metatarsal on his left foot. I thank you for your feedback I let him read your story, because he was so bummed yesterday. I am leaning toward surgery to fix the problem because of the instability and pain. One more question since you have had the surgery have you ever experienced (the kind of pain you felt like before the surgery that sharp popping pain) post surgery? That is the biggest reason I am for the surgery for him to be able to get back to a "normal life" eventually without the fear of feeling that level 10 pain from the instability that has  happened 4 times since Oct. I am figuring if he does this surgery it will be at least a year before he will be able to try and play soccer again with the hope that he would be able to play his Senior year (he is a Sophomore now)! THANK YOU and Franduke for your positive feedback, it was just what the doctor ordered. Sally

Hi there! I don't remember the mm of my dislocation (mine was a "sprain," aka a tear of the ligament rather than a fracture), but it was 1st and 2nd metatarsals (it's my understanding that that is the location of all Lisfranc injuries because that is the "Lisfranc joint"). I have had pain after surgery because the healing process is neither easy nor short. But I have not had any level 10 pain since surgery. I'm happy to answer any questions and talk about this, as mine went undiagnosed for 19 years and I'm so happy it was finally solved! I know exactly what it feels like to be so down about this . . . the fact that mine was not diagnosed meant that I could not do any physical activity for all of my teenage years, and it wasn't until I was in my 20s that I could actually start trying things (it seemed my body learned to compensate for a long time there), and then I had the surgery at age 29. I really feel that I missed out because I couldn't run, play any sports, etc. because the pain was so terrible. But having it diagnosed and then corrected could mean that the next many years of your son's life are so much healthier, and he will most likely be able to play soccer his senior year! My physical therapist told me I could run after about six months, but at that point I decided yoga was more for me anyway. I wish you all the best and am here for anything you need!

Sally here,  (Soccer mom) my son had surgery Feb 1st, gets his hard cast off this week and will be another month before they remove the screw. What kind of therapy did they have you do, any suggestions? Thank you so much for your reply, crutch sentence seems like forever!

The physical therapy was really light at first - not hard work at all, mostly heat, then ultrasound, a bit of stretching, massage, heat, and home for rest. Then we started some stretches - calf raises, toe moves, etc., and finally we built up to some cardio (like the elliptical forwards and backwards) in addition to some harder balance stuff (like balancing on each foot on the Bosu - I bet you can guess which side was harder!). I think that if you have a good doc, s/he'll refer you guys to a great physical therapist, who will know exactly what to do. Over time, the thing I really needed to work on was called "dorsiflexion" (check spelling) - basically, the flexibility of my foot as I walked, so it wasn't just flapping down onto the ground and back up, but actually moving forward on each part of the foot in a healthy, smooth way. Hard to describe, but hope this helps. Glad he's in the recovery stage!

Hi Franduke,
I just found your post. I have a Lisfranc from 2000 that was just diagnosed. I am booked in next week to get my 1st.2nd,3rd Metatarsal/Tarsals fused with pins and a plate and a graft.
I had a similar experience I did not have the searing pain that others experience at time of injury but knew something was wrong.
14 years later chronic arthritis.

My question is with all the years of over compensating and walking irregularly did this cause issues after you had been realigned?
I can almost stretch to the point where my foot feels in position but there is an incredibly strong force in my knee and around the injury that pulls it back out of place. I feel like there is so much more going on in the tendons and scar tissue in the ligaments than just bones out of place.

Just wondering if you experienced a similar thing and any complications?

Best Wishes

Will

_[removed]_

Hi Will! I'll email you!

Hello, I have a 13 year old lisfanc injury from a fall from a height down from 5 concrete steps carrying a box of cermamic tiles. Afterwards I could not fully weight bare for months and then got complex regional pain in it. I love to dance and run but now the foot becomes too painful and I am thinking of changing my lifestyle to non weight bearing activity for fitness. I am 44 and towards the end of my pregnancy 4 years ago I could not weight bear on it. I have a widening between the first and second mets. I have just had my MRI scan and WB x-ray. I am waiting to see what my consultant may offer me in terms of help. I wonder if it could be surgical. I just don't know yet. It really helps to read your stories and not feel so alone.

My son had surgery on same area 3 months after initial injury that was misdiagnosed. My advise is to get more than one opinion I had 2 opinions one saying she would not do surgery the other saying he could fix it. HE had surgery inserted screw 3 months nwb then removed screw and pt. IT worked for him! He is playing soccer again and in Lisfranc's terms has defeated the odds. He has had bone marrow edema flare up once after running on his foot constantly, but when he layed off it went away, so he has altered his cardio from just running to be more foot friendly. If you want more info, I would be glad to help.

Hi, I had injury 3 months back, was diagnosed late. One Ortho foot and ankle specialist recommended fusion and a different one tightrope. I have 3 mm dislocation between 1st and 2nd MT, I am able to walk with slight limp, its getting better every day. I am not sure whether to go for surgery or leave it as it is. Will there be any problem to wait until I get severe arthritis pain and go for surgery or better to fix it even though pain is manageable?

I'm the mom of the soccer player, same advice applies to your injury as I gave below to mother of one, get several opinions, take all xrays MRI's with you and get acquainted with the anatomy of the foot (if you are not already)! If you want to message me again with any other questions please feel free. Good Luck! Smiles,Sally!

I waited 14 years to have surgery on my lisfranc injury. I will admit, i always had a sore foot all those years but the injury didn't keep me from doing everything active i love to do. two years ago i trained and raced a half ironman and after the race i had cronic foot pain for about a year and didn't run until this past summer. And when i decided to run, i ended up getting a MRI a week later because the pain was so bad. Diagnosis was essentially no cartilage between 1st and 2nd metatarsal, bone spurs and lots of arthritis. I couldn't walk a block without a lot of pain so i had the surgery in October. 5 months out i am doing all activities besides running. Foot still sore but manageable. long story short, if you can afford the time off and have someone to take care of you for a 6 weeks i would do the surgery sooner than later. The damage i did to surrounding bones in the foot and ankle, stress of misaligned bones to the ankle which then effects the knee, along with minor arthritis in talus are all irreversible and will definitely give me problems later in life. I will say, the recovery from the surgery is rough but i also had to go back to work 2 weeks post surgery but i am weeks ahead of schedule on my recovery progress. Better to get the surgery over with than Wait until the problem is worse.

Hello K Steinbeck! Good to read your information. I am 14 years into a missed lisfranc injury. I was diagnosed on year 13. I'm a dancer and love to run but due to chronic pain I went to see a few surgeons and a great podiatrist. It has been confirmed I have an unstable joint and degenerative arthritis in the first ray, morton's neuroma and toe arthritis. I have been offered fusion of the midfoot. However, I am currently getting by with orthotics and no running or dance - just walking. I have been thinking of dancing on the arthritis with orthotics in shoe and avoiding surgery. However, I am told this will worsen arthritis. I also have an involuntary violent shake if I lift my heal off the ground slightly which will continue all day so I keep my foot flat. I have been told this is due to my body adjusting around the instability. I am still deciding on the correct surgeon. Would you recommend anyone in the UK? Are you in the UK? would love to stay in contact with you as you are a success story. Did you have fusion?