Lisfranc (Midfoot) Injury | Orthopaedics | Loyola Medicine

Lisfranc (Midfoot) Injury

Overview and Facts about Lisfranc (Midfoot) Injury

A Lisfranc (midfoot) injury occurs when the ligaments supporting the midfoot are damaged or the bones in the midfoot (metatarsals) are broken. The severity of this orthopaedic condition can range from minor to complex if many joints are involved. Sometimes mistaken for a sprain, a Lisfranc injury is not that simple and may require surgery, which can take several months to heal.

Signs and Symptoms of Lisfranc (Midfoot) Injury

Common symptoms of a Lisfranc injury include:

  • Pain throughout the foot that worsens when standing or walking
  • Pain that is not relieved by elevation or icing
  • Swelling on the top of the foot
  • Bruising on the top and bottom of the foot

Causes and Risk Factors of Lisfranc (Midfoot) Injury

Lisfranc injuries can happen if you twist a foot when falling. This is a common injury for football players who stumble when running. A Lisfranc fracture can also be caused by a more serious injury, such as falling from a great height, dropping something heavy on your foot or being involved in an auto accident.

Tests and Diagnosis of Lisfranc (Midfoot) Injury

Because Lisfranc injuries can easily be misdiagnosed, your doctor will carefully examine the affected foot, looking for signs of bruising that may indicate a torn ligament, fracture or blunt trauma, while also checking for tenderness and swelling surrounding the midfoot. You may be asked to try to stand on your tiptoes or to move your toes up and down to check for pain.

Imaging tests are typically used to confirm a diagnosis of a Lisfranc injury. An X-ray will reveal any broken bones or joints out of alignment. X-rays may also be taken of your uninjured foot for comparison. In cases of severe injury, an MRI or CT scan may be ordered, since they give a more detailed image of the foot than X-rays.

Treatment and Care for Lisfranc (Midfoot) Injury

Initial treatment should involve ice and elevation until seeing a doctor. Non-surgical treatment for a Lisfranc injury with no fractures or sheared ligaments usually entails wearing a cast for up to six weeks, during which time no weight should be put on the affected foot. After six weeks, you will be able to wear a weight-bearing cast until the foot has healed properly.

If your injury involves a bone fracture or torn ligaments, you will need surgery to repair the foot. Common types of surgery include internal fixation surgery, where internal implants are added to help repair the bone. Another type of surgery, bone fusion, is a procedure where the affected bones are fused to make one mass of bone. After surgery, when the cast has been removed, you will need physical therapy to help regain movement in your foot.