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I sustained a lisfranc fracture (2nd, 3rd & 4th metatarsals with significant displacement) on 05/08/2008. On 05/20 my orthopedic surgeon performed an open reduction with internal and external fixation (endo-button,k-wires, and 3 pins). The cast and pins (omg!!) were removed 5.5 weeks post op and I'm now in a boot with limited weight bearing and limited ankle flexion and extension.

I have had numbness on the top of my foot and toes and between my toes which has not improved since the injury. Also, my dorsiflexion is extremely weak and shaky. I understand this is indicative of nerve damage, of which the prognosis is unpredictable at this point.

I'm a 30 yo athletic female and I am very anxious to begin physical therapy to resume my pre-injured life!! I've managed to miss only 4 days of work and I've been driving throughout, which I'm grateful for considering the posts I've read, but I'm going crazy being unable to walk, etc.

I'd love to what kind of experiences and outcomes with physical therapy others have had with similar injuries. I'm 6 weeks post op now and ready to go!

1. What was the date of your injury?
2. How many weeks after surgery did you begin PT?
3. What was the frequency/duration?
4. How much function have you regained?

Has anyone with similar nerve damage symptoms experienced improvement of these symptoms with PT (or other) treatment?

Thanks comrades!!








Quote:

"It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience." -Julius Caesar

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The orginal date of my injury was 1/14/06. However I had to get my foot fused on 1/17/07.

I will try and remember what happened between the orginal injury and the fusion.

PT for me was about 8 weeks after surgery. I went 2 times per week. I was only about to go for 2 months. That is all my insurance would cover.

I had (and still have) that nerve damage you are talking about. Along with the Lisfranc injury I had a dislocated large toe that also did not help. My large toe and the one next to it never really recovered. It sort of feels numb like it would if your foot fell asleep. The pins that were in my two first toes also caused stiff toe joints that I was not able to ever get fixed afterwards. I really wish they never had put those pins through my toes.
I had bad arthritis develope in my foot and one year later I had the foot joint fused. The nerve damage is still there but no more arthitis pain.

Hopefully you will have a better outcome. Just follow all that your doctor and PT say to do. The worse thing you can do is to "rush" this kind of injury to heal.
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Dear CuteGenes007, I have had 3 lisfranc fractures through Irish dancing! One in 1997 to my left first and second metarsals, the next in 2005 to my right in the same place, and the third in 2006 to the left in same place again. I landed too high on point and the first metatarsal snapped forward severing the ligament to the second.

I did not require surgery as the bones popped back into place each time, and I just wore a roboboot (pet name) for about 7 weeks (bar the 1997 injury which went undiagnosed for 9 months).

I was able to return to competitive irish dancing each time after about 3 or 4 months of rest, the first 7wks in the boot. However I have residual weakness, and perpetual nerve issues. When I get nervous my feet tingle, and when I snowboard, they go completely numb within 10 minutes. I just went snowboarding 5 days ago and have retained numbness to the skin on my entire right big toe. Im sure feeling should come back soon!

Lisfranc's leave you with slight permanent disablements, but, seriously, if you think positively, and kiss your feet, they will love you back. I believe I have regained about 90% irish dancing capacity in each foot, and that really means 99% capacity for normal everyday activities. Unfortunately for me, its that latter 10% capacity that helped me win comps!
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I'm five months into this lisfranc injury. I landed wrong after hitting an overhead in tennis. I dislocated all the bones and tore all the ligaments across the top of my foot. My Dr. stabalized everything with four screws and two pins. It's been over a month since everything was removed. I'm doing P.T...lots of stretches and pool work. My big toe is still very numb and everything is very tight. This is a very difficult injury to recover from but I am trying to stay optomisic that I can one day return to sports. I am, was a very active 59 year old women.....skiing, hiking, tennis and dance. I would love to hear from anyone else with this injury.
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Hello all

I've been reading posts non stop all over the internet about lisfranc injuries and it is amazing to hear all of the different stories and recovery times. Here is my brief story. I'm 30 year old male and I injuried my foot June 9, 2010 and had surgery on June 24th at Duke University. I am currently 3 weeks past surgery and in a cast. I have 3 more weeks until I get this cast off and they will take an x-ray to determine if they can put me in a walking boot. My confusion lies here: After surgery the doctor told me I would be non-weight bearing for 3 months, just like most links to Lisfranc injuries say. but when I read peoples stories, I hear how people are out of their cast as early as 4 or 5 weeks and into therapy? Most of the stories I read, the people have way more screws, bolts, wires, pins in their foot than me. I have 2 screws in my left foot.

I am trying to stay positive. My problem is that I keep reading these posts about this injury. I am praying to start weightbearing before 3 months.

anyways, if anyone is going through this injury or has been through this injury and wants a pen pal to keep uo with during the process, please feel free to email me at ***this post is edited by moderator *** *** private e-mails not allowed **
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I hope everyone heals quicker than expected.

Chris
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I had my surgery in May and now almost the end of July I am finally out of the boot and walking lightly with arch inserts. The recovery from cast to boot was a bit painful but as an athlete my pain threshhold is a bit higher than a normal person. The best thing you can do to start towards recovery is work on what goes first from the injury. Work on the thigh muscle cause it will have atrophied by the time you get the cast off. Work in the pool as much as you can when you move to the boot. I am not a great swimmer but it helps my cardio and with the kickboard and water pedaling my leg and ROM get better every day. I am not a therapist so I am only working from what I can tolerate without fatiguing my foot. All indications are I will be fully recovered by the end of the year. Being an athelte the rule of thumb is heal completely and work hard but do not stress the injury as it could take longer. Unfortunately this is not my first but it is for this type. Patience is the key to successful recovery. There's always next year. At this time your body is the most important matter don't ignore it for things that can wait.
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My son sustained a lisfranc evulsion fracture of 1st & 2nd MT, 3 min. into the first football game of the year during his senior year of high school. It took about a week to obtain a correct diagnosis and another week to find the right doctor. He was devastated, and as his parents, so were we. At that time he had some fairly promising D-1 interest as a quarterback. After reading many of the horror stories on the internet, I knew all hope was lost for the current year, but was more worried that he would be dealing with this for the rest of his life. I did not however share any of the info with him. After seeking 3 different opinions, we went with an orthopedic foot specialist who placed 4 screws and fused two bones. (Fusion sounded very scary but after all I have subsequently read, I am convinced we made the right decision.) We were also very lucky to find this specialist who had performed many lisfranc repairs. This was key. Surgery took place two weeks following the injury. Eight weeks in NWB hard cast followed by gradual WB in boot over the course of next four weeks. Injury took place at the end of August and was finally able to put a shoe on in early January. Began PT and continued with it for next 4 mos. By mid January was able to attend a few D-II camps and, I am very happy to say that, on his birthday was offered a partial scholarship at one of these D-II schools. He has continued to work very hard and reports no issues with his foot at this time. He wears a regular orthotic in his workout shoes and a custom made in his football cleats. He previously was running a 4.7 40 yd. dash, however I am not sure that he is quite back to that as of yet. Some tips I would recommend would be, in order of priority:
1. Find ortho specialist who has experience.
2. Ask about nerve block during surgery. This lasts anywhere from 6-36 hours.
3. Begin pain meds as soon as any feeling comes back from the nerve block. My son had very little pain if at all.
4. If you need to be pretty mobile, get a lighter weight knee cart along with your crutches to get around. He attended a large high school.
5. If getting a knee cart, ask the person applying the cast to add a little more cushion to your shin.
6. Follow doctors orders. I was more than a little worried about this with a teenager, but he did quite well and it has paid off.

As I had read many of the horror story posts that you all have read, I promised myself that, should we come out of this with a positive story, I would post it, in order to show that there is life after a lisfranc injury. I wasn't real sure there for a while! But I am now very happy to say there is.
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Hey All,
I just had my Lisfanc surgery. 4 screws added. Chris, have no worries. I live in the same area but had my surgery at WakeMed. It sounds like you are getting the same basic advice I am getting. I have a partial cast now to allow for swelling and get the full cast next week. Then 3 more weeks, they put me in a soft cast that I can take off only for driving and then put back on. So, I won't be putting any weight on this foot for a while either. They said they wouldn't take the screws out for 6 months and from what I hear, you don't want to do much weigh bearing before those screws come out because you don't want to break them. Did they say anything about whether or not you should take your screws out? I think there are different thoughts on that. There has been no mention of Physical Therapy to me yet... I think that is way down the road. I am sure there are lots of factors that go into the decisions of when you can progress to the next stage. For me, I waited 2 months from the injury for the surgery, so most of my swelling and muscle damage had healed... just the bones weren't where they belonged and couldn't support any weight. This is definitely not a fun process, but from what I have read, the surgery is worth doing to avoid arthritis down the road. Plus, I hope to get the functioning of my foot back so I can get back into my active lifestyle.
So, I plan to relax, survive and put in the time for an optimal recovery. Hope everyone feels better soon.
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I am 5.5 years post Lisfranc injury and 4 years post surgery. Yes, I am one of the unfortunate ones who was misdiagnosed for over a year. Consequently more damage was done. Mine was quite severe, 4 dislocations, torn ligaments, ruptured tendon, and damage to the vegas nerve. It took 8 screws to put me back together, plus the rebuilding of my arch, repairing the ligaments, tendon and nerve. I, to this day, live with severe chronic pain. Due to the amount of time on crutches, a wheelchair, crutches and a walker againfor a total of 3.5 years, and now a cane, with constant limping , I have damaged my spine. I now have ruptured disks in L3, L4, and L5. I can no longer do the things I loved doing. Walking, hiking, shopping at the mall for hours, just working in the garden for a few hours kills me. I can't go to the grocery store without being in severe pain for the rest of the day. I have been on every pain med out there. I am on time released morphine now, which is a godsend, but it only lasts for 4 hours and I am prescribved only 1 every 8 hours thanks to a difficult Doctor who believes that pain medication should only take away 30% of the pain. Minimal is best. Hogwash I say! I have had 4 years of PT. It really does more damage than good I believe. For my back, I have had 7 injections of steroids which did nothing except cause a huge cataract in my right eye which I am now awaiting surgery for. I am also waiting for an appointment with a back surgeon. In November of "09, my Doctor and 4 psecialists put me on full disability status. I applied for social security disability and was awarded full disability benefits within 6 weeks dating back to the day of my injury. Yes Folks, Aa Lisfranc Fracture is grounds for full disability! If you can't work due to a career spent on your feet like mine as a hairstylist, a Lisfranc Fracture is grounds for full disability. Praise God. I nearly lost everything I worked for. I am now 54 years old, to young to feel this old, and feeling to old and broken to be this young. The good news is Jesus is my strength, the one I cry to, the one I go to when I think I can't live another day, the one I put my trust in. He has carried me through this nightmare every step of the way, even when I couldn't see it. Without my faith and relationship with him, I wouldn't be here. My sincerest wish for all Lisfranc sufferers is that not one of you has to go through what I have. God bless you all with hope.

Jodee
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Hello everyone,

I had the Lisfranc injury in Feb 2008. I am here to tell everyone that is currently going through it now to just be patient. I was a college baseball player (graduated now) when my injury occurred, and I had the works. I completely ruptured my ligament, dislocated my 2nd metatarsal, and even fractured my second cuneiform as well, so its safe to say that I suffered the most severe form of this injury. I had 3 pins inserted laterally through my first 3 metatarsals, along with fixation, and repair of the ligament. I am proud to say that I was able to make a full recovery, and even played out the 2 remaining years of my baseball career after the injury. After my surgery in early March, I was total non-weight bearing until June when I got the pins removed, and did not start weight bearing until I started physical therapy in mid-July. I went to PT for about 2 1/2 months, 2-3 times a week. I was not able to fully sprint until about january (possibly due to the fact that our athletic trainer did not clear me until then). Also, I was prescribed to wear an orthotic (a custom made shoe insert that my insurance, and most insurances should cover). My best advice is to follow the Physical Therapist's orders DIRECTLY. They know what they are talking about!. And please, you have to just be patient; if you try to rush your recovery, then thats where the problems start, and they will never go away. I am not sure this is what you want to hear as far as recovery length is concerned, but it was well worth it. I am completely active still, with almost no pain or trace of an injury to my foot. There is the occasional soreness after a rigorous workout, but nothing major. Hope this helps. P.S.-- I am now in physical therapy school because of my experience, and love everything that this profession provides. Any more questions? Feel Free to ask!
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Hello! This is the first time I ever replied on one of these. I have a Lisfranc fracture/dislocation as well... :( I got it when I was 16 years old!!!! A golf cart flipped over onto my foot squishing it on the cement with its tire. Long story. I was in so much shock that I pulled it out from under the tire, and thats when I heard pop pop pop! I broke 5 bones and dislocated two joints. Horrible. It was externally pinned ( 3 ) and that was that. I had a hard cast for two months and had to do phisyo for 4 months or so and I never played many sports after that. I just did what I thought would be fine, RUN! I was pretty poor and so I couldn't afford orthotics until just last year ( 2010! :( ).

Eight years later I am 24 now, and I have arthritis in my midfoot and I am having pelvis problems from limping. I have had two ''flare ups'' once just the beggining of last year in mexico ( I was wearing crappy shoes ) and another when I was doing hot yoga ( bending my big toe in the heat). Just recently I went to the best surgeon in the provice and he said that the longer I wait for surgery the better (WTF) since it is such an invasive surgery ( joint fushion where they take out one of the joints and drill it all back together). He said it is better when I am 30 or 40 years old also there will hopefully be some medical advances. Pretty horrifying. I am a bit depressed but I am trying to take this all in and learn from it. Buddhism has really helped. It has gotten me to meditate, become more spirtual and realise how fragile we all are and that the human body is an amazing gift. I am trying to be positive and the more I really try the better things seem to be. I currently am in phyiso once a week, ( its free ) and I see a chiropractor for my pelvis/ foot. I somehow go to school full time and have just until now realised that I have a life long disbility. I am currently working on the grieving process. After the second flare up, which happened right before school in September of last year, I had to drop all but one class and I was in a wheel chair for a month or so when we walked our dog ( my husband pushed me! ) I am a member of the Arthritis Society---- they have helped me out so much, all for free. I take Glucosamine, MSM,Chondrotin,WildFishOil, Vit E, Vit D and a really good calcium. They seem to help. I convinced myself that running sucks for your body anyway--- It helped me with coping without a good run. I have a pull up bar and work on my upper body ( totally helps with my mood ) and use the gym at my school to work everthing else out, even my feet. I am in pain everyday though somedays less. For example the pain I am in right now is a 4 out of 10. I walked a lot. I don't smoke cigarattes but I do smoke marijuana once a week and I find that the pain gets a bit worse but I just ignore it. I heard that it does something to your circulation? I am getting used to it though! I have a rolling backpack which is great, I use Nortic Walking Sticks ( They are the best! You look funny and people say a lot of comments about you liking to skii. They help with taking 20% weight off the and knees-- my friends at the arthritis society taught me--- plus it keeps my back straight and hip rotation to a minimum--less limp. They have removable feet- when you remove the feet there is a metal rod sticking out for when you go for a hike, for stability too.

One last thing. I have also thought of an actual amputation. If the pain keeps up like this and I get all miserable for 10+ years I will seriously think into it. I have talked to a lady with a similar problem ( she is 58 years old ) and she said it is the best thing she has ever done and that she shouldn't have waited so long. OKAY. Enough typing. Anyone have anything to add to help would be greatly appreciated. I hope this helps anyone out there. Anyone that has had a Lis Franc injury for 10 + years I would love to hear from you. Thanks for reading.

Recomended readings: Eckhart Tolle- ' A New Earth '
David S. Butler- ' Explain Pain '
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      Hey all! I have been reading alot about les franc injuries and I feel as though my experience has been slightly different than most.   I am a 24 year old male and up untill my injury I was very active, I  was competing in 5k races, mini marathons, bike rides, triathalons and had completed my first half marathon. Then on July 24th I was playing indoor soccer and took a sharp turn and felt my foot twist inside my shoe, it swelled up to the size of a ballon and after xrays and MRI's I was diagnosed with having seperated my les freanc ligament in my right foot. The doctor scheduled surgery on August 8th and he went in and put an elastic band in my foot stretching from the left side of my foot to the top middle. Two inscisions were made and post surgery swelling and pain was pretty terrible. After a week I was in a cast. After the surgery and after the injury I had lost feeling inbetween my two biggest toes and the whole time I was in the cast my nerves were going crazy and I lost alot of sleep. It was pretty awfull. I stayed in that cast for two weeks and then they took it off and removed the stiches. Then I was givin a walking boot to use ( I was still on crutches for I could not bare any weight nor was I supposed to). The swelling was still pretty evident and when I asked the doctor he said that my foot would be like that for a couple of months. Two weeks after that I went in and he said I can start walking with the boot on only and I was to start physical therapy. The two weeks after I had my cast off I did not wear my walking boot because I really wanted to move my foot. I wore it whenever I went out to protect it but I was more concerned with mobitlity. It has now been a month and a half after surgery and I am now able to put weight on it and I can feel myself getting better everyday. I even believe the feeling is returning to my toes.  It is so hard not to push it when I really want to be active again, and work and drive and just walk!!!! I know I am young and should heal fast and be fine, I just will never take walking or any physical activity for granted ever again, I cant wait to start swiming again, I believe that will do my foot alot of good. If anyone has any tips for rehabing a foot I am all ears. Please let me know

    Chris

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Chris your post gives me some hope! I was recently diagnosed as having a lisfranc fracture. I was injured on November 16th and had surgery on the 28th. Most posts that im reading mention pins, wires and multiple screws. However, i got lucky and only needed one screw. My big toe is numb which i expect with any surgery is normal. However, my nerves seem to go nuts at night which cause me to rest uneasy. I am now in a hard cast and go in for a follow up on January 5th. I'm hoping that I will be put in a walking boot. I live a pretty active lifestyle and I'm concerned that this injury is going to hinder my ability to continue doing so. I'd love to hear how you are doing now being that it's a few months after your post. How easy was it to walk again? Do you still suffer from any numbness or pain? Are you able to be active again? Hope to hear back soon!
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Hello all. I had a full lisfranc on my left foot (all five metatarsals).  Happened on August 6th and had surgery on August 11th.  No weight bearing for 2 whole months, then a walking cast with a slight/little by bit weight bearing, then after another month, a walking boot.  On December 6th I had a secondary surgery to remove the hardware so the ligaments and nerve damage can heal properly.  I had five screws inserted one on each metatarsal as I had all of them misplaced and a nasty injury. 

The research and information on the internet can be helpful but also daunting . . . I had amazing care in regards to doctors go and will start physical therapy next month, January 2012.  So all in all, it has been almost a half year (6 months) injury process and I still can't walk.  I have dragged my foot around when I had the boot off at home for a short distance and had a better feel for my foot.  I have severe nerve damage and numbness.  Stiffness is pretty bad and athrophy is pretty bad as well.  I'm a tall woman (6 feet tall) and was extremely active prior.  The most discouraging feeling is not being able to move and do the things that hinder your lifestyle (we all need to move).  I have joint, nerve and pain obviously from the surgery.  I have friends in the sports athletic medicine field and am around pro athletes . . . the best suggestion that was/is given to me is to be patient and do what the doctor say/says.  It is extremely difficult and the desire to push myself to walk is there and to move and do more, which I have every now and then, but at the end of the day, the longterm result is affected if you push your foot to move prior to when it should.  The catch is if you do too much at the beginning to walk/and get moving, you hinder your longterm healing . . .

My biggest concern is the longterm affect and the longterm healing . . . from what I've seen and heard full mobility is hard to attain after such a serious injury, but I'm confident that doing what the doctors, surgeons and physical therapists tells us to do, things will move along.  It is an injury that requires patience, which we all tend to not have, because we all want to move on with our lives (at least that is my main frustration).  One of my doctors tells me that swimming can be a big player in helping your/our/my healing process when it comes to a lisfranc fracture/dislocation.  I am willing to deal with the pain at this point for as long as it takes so I can get my foot moving and back to where it was.   

All the screws are now out.  I will need some toe correction on my big left toe since the injury was pretty extensive, but that is the least of my concerns at this point.  All metatarsals are back in place (yes all five were moved and dislocated), I don't feel most of my foot, I can't move much of it other than a slight up and down motion even if I try and push it to go anywhere.  I also had a few fractures along with the lisfranc, and I don't even have a cool fun story of how the injury happened.  I simply slipped on the tile floor of my house and voila . . .

If any of you have had this injury and a significant time has elapsed, a few years, I'd be interested in knowing of how your lifestyle in regards to activity and mobility have been affected and if you have gained full motion and kept the standard of living in regards to activity the same as prior to injury.  I get discouraged every now and then when I think of the longterm effect of this . . . but am trying to stay positive and obey doctors orders so I can restore my lifestyle prior to the injury.

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Hello Everyone, these posts have shed some light on this rare injury. However, I hardly see any 'success' stories and I plan on being one no matter what it takes. Before my injury, I was a very active person and I usually spend about 1.5 hours ago in hard activity. I took up Muay Thai 3 weeks ago and in the 2nd week, I started doing kick training. I struck the punching bag full tilt with my midfoot instead of my shin and I buckled immediately. It swelled abnormally and the next day, I went to emerg where I was put into a cast and told to wait a week until the fracture clinic could see me. When I went, the specialist said that I had the injury and that I'll have to do a CT scan to assess the depth of damage to my foot. The x-ray showed a single fracture, but the doctor was concerned with any tendon damage. He informed me that the CT images will determine whether I need to go into surgery or not, but suggested it was highly likely. the swelling is on an off, when my foot is raised and iced the swelling calms down with the exception of a large bump protruding from the fracture point. I can zombie walk with airboot, but the pain starts after an 'x' amount of steps.

I'm just so anxious to go back to my normal life of being active and on the go. It's such a bizarre experience; I never paid attention to the small things in my body that kept me going and now that a single 'split-second' move crippled me, I dearly appreciate the seemingly simple functions of my body. I wish godspeed to everyone who is suffering with this injury and I hope I have the patience to get through this like the rest of you.

Neil.
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