Our feet are one of the most complex areas of the body, with each foot containing 19 muscles, 26 bones, 33 joints, and 107 ligaments. Out of the 206 bones in your body, that’s 52 bones in your feet alone. While this structure makes it easy for us to move and flex as needed, it also means that an injury to this area requires a podiatrist or foot doctor to treat due to its complex nature. When it comes to injuries of the foot, the midfoot fracture or LisFranc injury is commonly missed since it can be confused with other injuries like a simple sprain. In this article, we’re going to go over what a LisFranc injury is, how you can recognize one, what the different types are, and how it is treated.
What Is a LisFranc Injury?
Let’s first identify what exactly the LisFranc is. The foot is complex enough that podiatrists divide it into three parts for ease of conversation: The forefoot, midfoot and hindfoot. The hindfoot consists of the heel and ankle, while the forefoot is composed of your toes and the bones that support them, the metatarsals. Finally, the midfoot contains all the bones that make up the arches of your feet. The LisFranc joint refers to the collection of bones and ligaments that connect the metatarsals to the midfoot, and is located right in the middle of your foot, just in front of your ankle. With all that said, an injury in this area is referred to as a LisFranc injury, and includes damage to the bones, ligaments, or both, often coupled with damage to the surrounding cartilage.
What Are The Main Causes Behind a LisFranc Injury?
This type of injury often occurs either when something heavy is dropped on the foot or when the foot is twisted while flexed. While a relatively rare injury, podiatrists often see it in those who play contact sports like soccer or football. It is also seen in individuals like runners, military personnel, and horseback riders, due to heavy foot use or falling. However, it can also occur during low-impact missteps, such as missing a staircase or twisting too far during a fall.
What Are The Symptoms of a Midfoot Injury?
If you have pain in your midfoot area and are unable to bear weight, it is critical to visit a podiatrist located in [location] to have it looked at immediately. Make note of which types of symptoms you are experiencing as this can indicate which type of LisFranc injury you are experiencing and help the ankle doctor during their assessment of you. Look for any of the following symptoms.
Swelling in the foot - midfoot area.
Pain throughout the midfoot area when applying pressure to it.
Pain throughout the midfoot area when trying to stand.
Bruising on the top or bottom of the foot or along the arch of the foot (side in the middle).
An abnormal widening of your foot.
Depending on the location of the LisFranc injury and what type you have, the symptoms may vary. You may experience all of the above or any combination of them. If you cannot get checked out by a foot doctor right away, be sure to stay off your feet and use ice and elevation to reduce swelling.
Understanding the 3 Types of LisFranc Injuries
There are 3 types of LisFranc injuries you can experience, sometimes one at time or sometimes in combination with one another.
A LisFranc sprain occurs when you stretch the ligaments within the midfoot causing instability in the midfoot joint. This happens because the ligaments in the midfoot along the bottom are stronger than those on top.
A LisFranc fracture happens when there is a break in any of the bones that make up the LisFranc joint. The most common are avulsion fractures which is when a small piece of bone is pulled off or away. Although, you can completely break bones in the midfoot as well.
A LisFranc dislocation is when the bones in the LisFranc joint are forced out of their normal positions, causing a dislocation.
How Are LisFranc Injuries Diagnosed & What Is The Standard Treatment?
When you visit a podiatrist located in [location], they will ask about how the injury occured and they will examine the foot to determine the severity of the injury. They may take a medical history to see if this is the first time you’ve experienced this type of injury
or if you’ve had previous injuries that may have increased your risk for a LisFranc injury. If a podiatrist concludes that a LisFranc injury is present, they will x-ray the area to confirm their diagnosis.
When it comes to treatment, a podiatrist will determine if surgery is needed or not. If you have fractured a bone in the midfoot, dislocated it, or torn any of the ligaments, surgery is likely. Otherwise, you will be recommended to do a combination of the following:
Use a cast. Immobilizing the foot and keeping pressure off of it allows it to heal.
Take medication. Anti-inflammatories such as ibuprofen help reduce pain and swelling.
Use ice and elevate your foot. A common technique used to reduce swelling.
It is common to use the above treatment methods for 6-8 weeks while your foot heals. Once you are able to bear weight on it again, you may be required to attend physical therapy to rebuild strength in your foot again.