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Lisfranc Injuries: Midfoot Sprains, Fractures, and Dislocations

Updated on July 31, 2013

Houston Texans quarterback Matt Schaub was out for the 2011 season with a Lisfranc injury. Learn more about this painful midfoot condition.

Houston Texans quarterback Matt Schaub.
Houston Texans quarterback Matt Schaub. | Source

Painful Midfoot Injuries

Matt Schaub's "significant foot injury" made recent news in American sports. The Houston Texans quarterback was out for the season with a Lisfranc injury.

It was devastating news for Houston players and fans, who hoped to see Schaub in the Super Bowl if the Texans made it to the 2012 National Football League (NFL) championship game.

The news also had many fans looking for information on Lisfranc injuries: what they are, why they happen and how they are treated. This hub addresses their questions.

Lisfranc injuries are those sustained to the Lisfranc joint in the middle of the foot, the connection point between the short tarsal bones in the arch and the long metatarsal bones that extend to the toes.

Lisfranc injuries and the Lisfranc joint get their names from a 19th century French surgeon, Jacques Lisfranc de St. Martin. The doctor pioneered numerous surgical operations, including foot amputations.

During the Napoleonic wars, when many soldiers experienced frostbite and gangrene, Lisfranc discovered a way to make amputation easier by cutting through the joint spaces.

Lisfranc Injury Causes

Lisfranc injuries are most often seen in car accident victims, military personnel, horse riders, runners, football players and athletes in other contact sports.

However, even common accidents around the house -- missing a stair step, for example, or dropping a heavy box on the foot -- can cause a Lisfranc injury.

These midfoot injuries result from some type of trauma, direct or indirect, to the foot. A direct cause, like dropping something on the foot, involves direct damage to the Lisfranc joint and bones.

An indirect cause, such as stepping in a hole, usually involves twisting the foot, stretching the ligaments or dislocating the joints.

X-ray of a traumatic Lisfranc fracture.
X-ray of a traumatic Lisfranc fracture. | Source

Lisfranc Injury Types

According to the American College of Foot and Ankle Surgeons (ADFAS), there are three types of Lisfranc injuries: sprains, fractures and dislocations.

  • Sprains involve stretched Lisfranc ligaments on the bottom of the foot. The weakened ligament causes joint instability in the midfoot region.
  • Fractures involve bone breaking in the Lisfranc joint. Fractures can include a break through a midfoot bone (or bones), or a small break that chips the bone.
  • Dislocations force Lisfranc joint bones out of their normal positions.

Lisfranc injuries, whether sprains, fractures or dislocations, are often mistaken for ankle sprains.

Lisfranc Injury Symptoms

Lisfranc injuries are painful injuries. The top of the foot is usually swollen and bruised. The arch is also bruised and blistered. Any pressure, even standing, causes pain to the middle of the foot.

Severe Lisfranc fractures can make it impossible to bear weight on the foot. Unrecognized and untreated, Lisfranc injuries can lead to other complications such as joint degeneration and compartment syndrome, the compression of muscle, nerves and blood vessels that may cause tissue death and loss of limb.

Foot and Ankle Guides

Baxter's The Foot and Ankle in Sport, 2e
Baxter's The Foot and Ankle in Sport, 2e

Book by David A. Porter and Lew C. Schon / Format: Hardcover Edition


Lisfranc Injury Treatment

The treatment for Lisfranc injuries depends on the injury's severity. Patients may require surgical or non-surgical treatment. Orthopaedists treat Lisfranc injuries in one or more ways:

  • Ice / Elevation. Ice and elevation are usually the first step in treatment. Applying ice to the injured foot, and keeping it elevated, reduces swelling.
  • Immobilization. A cast immobilizes the injured foot, and crutches limit weight-bearing and keep pressure off the foot.
  • Medications. Doctors usually prescribe analgesics and nonsteroidal anti-inflammatory medications (NSAIDs) to relieve pain and reduce inflammation.
  • Physical Therapy. Physical therapy promotes healing after the swelling and pain subsides, through foot exercises that build strength and restore range-of-motion.
  • Surgery. Certain injuries may require operative treatment or emergency surgery. Pins, wires, and screws stabilize bones and enable healing. A cast and arch support assist healing. The development of arthritis in the Lisfranc joint may require bone fusion.

Reference Sources / Further Reading

Health / Medical Disclaimer: The information presented on this website is not intended as health or medical advice, and it is not a substitute for professional diagnosis and treatment by a qualified health care professional.

Matt Schaub of the Houston Texans suffered a lisfranc injury in 2011.
Matt Schaub of the Houston Texans suffered a lisfranc injury in 2011.

Copyright © 2011. Annette R. Smith. All rights reserved.

Published: October 15, 2011 / Modified: July 31, 2013.

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