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Hello, I suffered a Lisfranc Fracture on July 14, 2012. I tore all five metatarsals on my left foot and went in for an ORIF surgery the next morning, where they placed four screws. I was put in a cast for ten days, which was taken off on on July 26th and saw my surgeon who explained the severity of this injury. He told me I wouldn't be walking for six months and that I will have complications for the next fifteen to twenty years. They gave me an air cast boot during this appointment as well. My follow appointment was six weeks after I sustained the injury on August 23rd. I was told the injury was healing really well and was given physiotherapy to start weight bearing. The doctor also told me that on my next visit in another six weeks, they would get me off the crutches. I exercised my foot everyday and took it really easy, I suffered VERY little pain during this time and my foot become very strong. My toes and ankle moved just as they did before the injury. I also kept my foot elevated for a lot of the time and I know have very little swelling. I went for my next examination yesterday, a little after eleven weeks since the surgery where they took x-rays of me weight bearing. The doctor poked around my foot, asked me how the pain was going and told me I don't need to be using the crutches and I should have been weening out of the boot. This doctor was not my surgeon, but spoke to him about what I should do next. He came back to me and told me no more crutches and no more boot because it's slowing me down. He also asked whether I thought I needed physiotherapy, I said I wasn't sure and he grabbed my foot and stretched then said I didn't need it. They usually tell me when to come back for the next appointment, but the doctor told me to follow up as I needed but if I have any trouble just to make another appointment. I walked out of the hospital in the boot with crutches, but switched for my Doc Martens (which the doctor said were great sturdy shoes to be wearing) in the car park and practiced walking for the first time in three months without crutches and a boot. They gave me no information on what I should be doing, whether I can walk around barefoot or not. I am terrified because I now have an awful and quite uncomfortable/painful limp. My leg suffered atrophy as well so it's very weak and hard to walk on. I'd just like any information or tips as to what I should be doing because I'd like to have a normal life again and not have this cause any more difficulties for the rest of my life.. I'm turning 21 this month and not knowing how to care for this injury correctly will ruin a lot of things for me. I've been very positive throughout the past three months but just one day of trying to walk normally again has ripped me of all self confidence. Should I be wearing orthotics for arch support and can anyone suggest any shoes that would be comfortable to be wearing at home? And is there anything else I should be cautious of? I am not working and haven't been, I am a waitress so I'm very worried about how difficult this may be! Any information about walking after this injury would be greatly appreciated!

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I feel your pain, literally and figuritively...lol.  I had my lis franc injury 6 years ago.  I will spare you my long story and how and why and all that, but I had surgery, 5 pins put in, pins taken out three months later, did the cast and then the air boot, and was in a wheelchair because I wasn't coordinated enough to do crutches.  It was four months after my surgery that I was given the okay to start to put weight on my foot.  The doctor didnt recommend physical therapy to me, but I asked about it and he said I could try it, but didn't seem to think that much of it.  I can tell you, it is the best thing I did so I would recommend it.  The physical therapist had me custom fitted for inserts and recommended New Balance shoes.  I went to physical therapy for about two months if I remember correctly.  PT helped me to strengthen my foot, my ankle, leg, and taught me how to walk right again as I wasn't flexing my foot as I had been before.  I had A LOT more follow up with my surgeon than it sounds like you did.  I had an appointment and Xrays about every two weeks for 5 months, could be because I had two infections while I had the pins in (which is so so painful).  Anyway, now (6 years later) the bad news is that my foot still bothers me.  I have pain in the top of my foot which increases with the amount of activity I do.  I am not able to have a job that requires constant standing.  Ive heard from people who have had better outcomes than mine, and worse outcomes....I hope you are able to do everything you want to do!!   Im 31 and the injury has definately impacted my life and still does.  In sum, I would recommend PT, inserts, good shoes, and walking and exercise.  Hope this helps! 

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I had a Lisfranc fracture and surgery in August and am now 6 weeks post ORIF surgery.  My injury was less severe than yours - only 2 screws.  You seem so unsure about walking that you should call or email your doctor and ask to be referred for PT.  You are young and no doubt will return to walking very quickly. However, several weeks of NWB leads to a weakening of the muscles so that patients need help in strengthening the ankle and muscles. And overall reassurance that things are progressing appropriately.   

Many patients are returned to walking in a very slow way ---- First, by using crutches  and a boot with less than 100 percent weight on the injured foot.  The patient might use just the toes and then increase to the whole foot touching the ground, but still using the crutches and boot.  It depends on the injury, age of patient, and other factors that you need a doctor to provide advise about.  

So follow up with the doctor and get back to walking soon.  

 

Waiting for Light

 

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khut-aten wrote:

Hello, I suffered a Lisfranc Fracture on July 14, 2012. I tore all five metatarsals on my left foot and went in for an ORIF surgery the next morning, where they placed four screws. I was put in a cast for ten days, which was taken off on on July 26th and saw my surgeon who explained the severity of this injury. He told me I wouldn't be walking for six months and that I will have complications for the next fifteen to twenty years. They gave me an air cast boot during this appointment as well. My follow appointment was six weeks after I sustained the injury on August 23rd. I was told the injury was healing really well and was given physiotherapy to start weight bearing. The doctor also told me that on my next visit in another six weeks, they would get me off the crutches. I exercised my foot everyday and took it really easy, I suffered VERY little pain during this time and my foot become very strong. My toes and ankle moved just as they did before the injury. I also kept my foot elevated for a lot of the time and I know have very little swelling. I went for my next examination yesterday, a little after eleven weeks since the surgery where they took x-rays of me weight bearing. The doctor poked around my foot, asked me how the pain was going and told me I don't need to be using the crutches and I should have been weening out of the boot. This doctor was not my surgeon, but spoke to him about what I should do next. He came back to me and told me no more crutches and no more boot because it's slowing me down. He also asked whether I thought I needed physiotherapy, I said I wasn't sure and he grabbed my foot and stretched then said I didn't need it. They usually tell me when to come back for the next appointment, but the doctor told me to follow up as I needed but if I have any trouble just to make another appointment. I walked out of the hospital in the boot with crutches, but switched for my Doc Martens (which the doctor said were great sturdy shoes to be wearing) in the car park and practiced walking for the first time in three months without crutches and a boot. They gave me no information on what I should be doing, whether I can walk around barefoot or not. I am terrified because I now have an awful and quite uncomfortable/painful limp. My leg suffered atrophy as well so it's very weak and hard to walk on. I'd just like any information or tips as to what I should be doing because I'd like to have a normal life again and not have this cause any more difficulties for the rest of my life.. I'm turning 21 this month and not knowing how to care for this injury correctly will ruin a lot of things for me. I've been very positive throughout the past three months but just one day of trying to walk normally again has ripped me of all self confidence. Should I be wearing orthotics for arch support and can anyone suggest any shoes that would be comfortable to be wearing at home? And is there anything else I should be cautious of? I am not working and haven't been, I am a waitress so I'm very worried about how difficult this may be! Any information about walking after this injury would be greatly appreciated!


I had exactly the same injury as you in Sep 11, dislocated all 5 metatarsals and was operated on first thing next day as I had been admitted through A & E on a Sunday night. The doctor in A & E frightened the life out of me by telling me how serious my injury was and that I would always have pain in my foot, be unable to walk for long and get arthritis. Just what you need when you are lying on a bed waiting to be admitted. Initially I had been relieved that I had not broken any bones but then realised that what I had was worse as bones heal quicker. I also read everything on the internet which made things ten times worse. The consultant told me that after one year my foot will be the best it will ever be. I have 2 pins in my foot and have opted to leave them in as they are not bothering me. I can go back later and have them removed if they snap. So after one year, I am walking fine. My limp, which seemed to last forever now only sometimes occurs after I have been walking a while . I can now climb over stiles and walk up and down hill. I am still wearing flat shoes, not orthoepaedic, and wedges. Normal flat ballerina type are great and had no problem with flip flops on holiday. Gave all my high heels away but you never know, My main fear was falling which is physchological and I am over that now. My left leg was initially weak and I had pains at the top and my buttocks due to lack of muscle use to start. It is still really early days for you and you are only young so you need to be positive. I am 51. my symptoms now are occasional twinges and aches in my foot, more so in the cold weather and the top of my left foot is slightly more rounded . I have bought normal boots to wear and shoes. I suggest you buy a walking stick which was a godsend to me once I was confident to get rid of my boot. It also helps you if you are out shopping and get tired. I no longer need it and can walk around all day no problem. Hope this helps.

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I suffered a Lisfranc fracture the day after you, July 15th!  I fractured/displaced my 1st metatarsal, and fractured my 3rd.  Had surgery on July 26th, getting 2 screws for the dislocation.  I was in a splint, followed by a hard cast for 4 weeks, followed by a non-weight bearing walking boot for another 4 weeks (phew, lol).  My surgeon was very adamant about not putting any weight down for that time period to allow for healing.  I was given the clear to start WB on Sept. 24th, starting with heel-touch walking, working my way up to 25% body weight by the next week, and increasing by 25% every week.  Today is the day I'm supposed to be 100% crutch-free walking  :)  I would definitely not go straight from not walking to walking without support. 

That first day I put any weight down, I was SURE I'd never get to 100%, it was a devastating realization that my muscles just weren't ready.  The surgeon told me to get a scale and step on it with the injured foot, putting down enough pressure to get the scale to read 25% of my weight, and "memorize" that feeling, so I knew how much pressure I should be putting down by the end of the first week.  In the beginning, 25 lbs felt like a TON of weight, and I couldn't imagine ever being able to put it down without pain.  After about 4 days, I stepped on the scale again, and 25 lbs wasn't hard at all!  It's quite a rush to step on the scale every day and see the number going up without pain!  Over the last few days I've started walking without crutches, and can manage walking around the house barefoot for a few minutes.  Don't push yourself, your body is amazing, and it will heal if you give it the chance  :)

Good luck to you!

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I just got the go ahead to walk. I did not have an operation but had a nondisplaced lisfranc injury. He told me to just wear a sneaker (and alternate with boot if any pain). He said i didn't need orthotics (I wear New Balance). He said important thing is to do it slowly and listen to your foot.
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Hi! I received my Lisfranc injury 08/20/12. I was non-weight bearing for 7 full weeks. I have been walking with crutches for the past two and it isn't going well.
I saw your post - how is it going for you now?
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i've been to one physical therapy and it helped a lot. still pain in the midfoot and stiffness but it's only been a week. Was your lisfranc fractured metatarsals or ligaments?

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The CT scan showed I dislocated metatarsals between 1 & 2 with a chip off of 1. I broke 4 pretty bad and of course since I broke 4 - 3 came along with it. Ligaments torn too.
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wow how bad were the dislocations? i broke 2, 3 and 4 but he says nothing is dislocated. 2, 3 and 4 all broke at the base and 2 was comminuted. He said i'll likely get arthritis but that different people respond to pain differently with arthritis. It's frightening to think I might not ever walk normally again! How do you mean the crutches aren't going well. Are you weightbearing?
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The dislocations weren't bad (he explained it like I broke the lock but I didn't break it bad enough that the key doesn't fit in). I can't walk without the crutches - I can't put enough weight on my foot without tears and pain. In the past few days I have been able to stand on my two feet unassisted... I feel like one step forward and two leaps backwards. I will have a good afternoon followed by a day filled with horrible pain and new bruising. I go back to the dr on 11.08.12. I was hoping to be out of the boot at that time and driving by Thanksgiving - now I am not so sure. (of course I damaged my right foot - driving foot). My husband hates that I read about this injury - everything you see on it is so BAD... isn't anything good?

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yeah i know how you feel. so you are on crutches with the boot? I was nonweightbearing for 10 weeks before he'd let my foot touch the ground. I had to wear the boot to bed for 6 weeks. I had a lot of pain last week when i first started bearing weight with the boot, without crutches but I feel somewhat better this week. I think it just takes a lot of time..and patience. can you go to physical therapy? they help. A lot of the pain is stiffness and scar tissue (they explained to me) - they bend your toes (in frightening ways) and eventually will teach me how to walk again (they told me not to try until they'd worked with me). I don't think doctors communicate very well. So i think the good is that it takes time but that if you work at it it will get much better. That's why you have things like this forum and us to talk to!
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I wore the boot to bed for 5 full weeks... now I wear a lace up boot. The lace up boot I will most likely wear for at least a year (after I am out of the "cam" boot). I am waiting to hear about PT when I go back on the 8th. Eventually. That is the word I have grown to dislike.... Eventually it will be better, Eventually with time - waiting for EVENTUALLY sucks. It took me 6 weeks to become (really) depressed about my injury - I like to think I tried to keep my chin up before that. At 8 weeks I wanted my life back. Now at 10 weeks (today) I want relief.

 

foothealer, thank you. It's nice to talk to someone else.

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yes i went through the depression stuff too. it just seems to go on forever. Today has been a good day. Not pain free mind you but...better. I still use the crutches but put equal weight on both feet. Maybe i'm optimistic because the pain at midfoot seems ever so slightly better than it did last week... I agree with you that it's very hard for anyone to understand what this feels like. I certainly never gave a moments thought to the feet and how critical they are to our happiness!
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Hi, I wrote last week, and I'm coming back with a little update...

In the beginning I was really depressed too, it seemed like every new "milestone" made me depressed all over again.  First I was discouraged I couldn't walk easily on crutches, then when I got used to that, they put a new splint thing on me that was heavy, so it was hard all over again.  After that came surgery pain I had to deal with, then a cast.  I counted down the days 'til that cast came off and I went into the boot, I was SURE it would be an amazing experience, life would be easier, etc.  When I got the boot on I cried for a full 3 hours...my leg was SO tiny and wouldn't move the way I wanted it to!  I tried to take a full bath (that is one good thing about boot vs cast, lol) and it was more of a hassle than it was worth...first I had to climb stairs, then try to manage the tub, then have my husband's help getting out and dressed.  I sat on the stairs afterward and just cried...that night I learned I can't make my expectations too high, or I'll just end up feeling depressed over everything.  So I started focusing on the "good" things.  Like, in the boot I could take it off to soak the dead skin off, or start rotating my ankle to get some muscle built back up, or SCRATCH if I itched.  I took every single tiny good thing and ran with it, lol!

So my update...I went for my follow-up appt a week ago (3 months post surgery) and the doc released me from the boot!  So now I'm full time walking in shoes or barefoot.  :)  The first few steps always hurt, and I still limp, but after a few feet of walking, my foot "gets used" to it...I still can't wear sandals, my toes won't grip them the right way, but I can walk around my house freely and stand long enough to cook dinner or wash dishes comfortably.  Hang in there, guys, it does get better little by little!

Oh, also about the toe range of motion.  When I first was given permission to start walking, I asked the doc about it because I could NOT move my big toe at all without feeling a pulling sensation all down my foot.  I was fairly certain it was my screws I was feeling, lol, and that it wouldn't get better until they decided to remove them.  He told me it was scar tissue, and then showed me how to (fairly aggressively) rub the top of my foot to break it up and get more range back.  I've been rubbing vitamin E lotion on it every night, rubbing as hard as I can, and I'm now to the point where I can pick things up with my toes, they can bend so far!  Another thing I discovered is that they can bend further while I'm in the bathtub, so I give them a massage in there too, so they can get used to bending further.

Just wanted to put my "semi-good" update, since there IS so much bad stuff to read about this injury.  My husband tried hard to make me stop reading, because it contributed to my depressed mood, but it's HARD to stop, I just wanted to know exactly what I was in for!  Good luck to you both!

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