Lisfranc (Midfoot) Fracture

The Lisfranc joint connects the bones of the midfoot and forefoot, and is supported by the Lisfranc ligament. Injuries to this area may cause the ligament to stretch or tear, or bones to fracture or get displaced. Lisfranc fractures may occur as a result of a blow, forceful twisting motions, dropping something heavy on the foot and is more common in runners, military personnel, football players and horseback riders.

Symptoms include pain on standing or applying pressure on the area, swelling over the midfoot, bruising on the undersurface of the foot, and if severe, inability to bear weight.

To diagnose Lisfranc fractures your doctor reviews your medical history and performs a thorough physical exam of your foot. Bruising on the sole helps identify a Lisfranc fracture. Your foot may be further examined under anesthesia. Imaging studies are ordered to locate the fracture, check for displacement of the bones and ligament disruption.

Immediate treatment involves elevation of the leg, immobilization, and application of ice to reduce pain and swelling. Pain medication will be provided. Your doctor may place your foot in a cast for 6 weeks with no weight bearing after which a walking boot may be applied with gradual weight bearing. Physical therapy is then ordered to improve strength and range of motion. Displaced fractures usually require surgery to bring the bones into alignment and stabilize the joint with screws and a plate if necessary.

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