1. A Joint You Likely Don't Even Know You Have
Your foot can basically be broken down into three parts: your toes, your midfoot and your hindfoot, or heel. The long bones of your toes (the metatarsal bones) meet the bones of the arch (tarsal bones) at the middle of your foot. A strong ligament and tissue connect these bones at the top of your foot This point is known as the Lisfranc joint, so named after Jacques Lisfranc, a field surgeon who named the joint after amputating a soldier's foot while serving in Napoleon's army.
2. The What and Where of Lisfranc Joint Injuries
A Lisfranc joint injury occurs if there is trauma to the top of the foot. This can happen in a car accident, a contact sports injury, a fall or a direct blow to the top of the foot. There can be a strain of the ligament at this joint or a fracture or dislocation of the bones in the midfoot. One of the most recognizable signs of Lisfranc joint injury is bruising or even blistering of the arch. Other symptoms include swelling, inability to bear weight on the foot, pain at the top of the midfoot when standing, tenderness and possibly bruising on the top of the foot.
3. A Most Misunderstood and Uncommon Injury
Lisfranc joint injuries are uncommon and often difficult to diagnose. Physicians will not ordinarily consider the Lisfranc joint in their initial prognosis. Injuries to this joint don't always show up on x-rays. It's best to have the x-ray while standing to best see any dislocation or separation of the metatarsal and tarsal bones. An MRI or CT scan will better determine a Lisfranc joint injury. Most often, this type of injury is mistaken for an ankle sprain.
4. Getting You Back on Your Feet
Once a proper diagnosis has been made, you can now follow the necessary treatment for a Lisfranc joint injury. You'll be better off if there is only a strain to the ligament. For this type of injury, most commonly a removable plastic cast is placed on the injured foot for up to six weeks. Ice and rest are also prescribed. The cast can be removed for necessary physical therapy sessions. Fractured or dislocated bones in more severe cases may require the surgical insertion of pins or fusing of the bones to treat the injury.
5. When It Comes to Lisfranc Joint Injuries, the Fat Lady May Never Sing
There is the potential for lingering effects of Lisfranc joint injury, depending on the severity of the damage. For bone fractures, dislocations or separations at this joint, long-term complications include osteoarthritis and even foot alignment problems. There is also a risk of compartment syndrome associated with Lisfranc joint injuries. This results in pressure building up in the tissues of the foot, leading to possible damage to the nerves, blood vessels and muscles in the foot.
