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Lisfranc Injuries: Midfoot Sprains, Fractures, and Dislocations
Houston Texans quarterback Matt Schaub was out for the 2011 season with a Lisfranc injury. Learn more about this painful midfoot condition.
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.
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.
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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
- ASFAS. (December 18, 2009). "Lisfranc Injuries." Foot Health Facts (American College of Foot and Ankle Surgeons). Retrieved November 15, 2011.
- Israel, T. Andrew. (2001). "Lisfranc (Midfoot) Fracture." American Academy of Orthopaedic Surgeons. Retrieved November 15, 2011.
- Schefter, Adam. (November 14, 2011) "Texans QB Matt Schaub out for the Season with Fractured Foot." ESPN News Service. Retrieved November 15, 2011.
- Wedro, Benjamin C. (December 3, 2007). "Lisfranc Fracture: Diagnosing a Foot Injury." eMedicine Health / WebMD Medical Reference. Retrieved November 15, 2011.
- Wikipedia contributors. (November 15, 2011) "Lisfranc Fracture." Wikipedia, the Free Encyclopedia. Retrieved November 15, 2011.
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.
Copyright © 2011. Annette R. Smith. All rights reserved.
Published: October 15, 2011 / Modified: July 31, 2013.
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