Lisfranc's Injury (Fracture Dislocation)
What is Lisfranc's injury?
Lisfranc's ligament connects the medial cuneiform bone (one of the tarsals) to the base of the 2nd metatarsal. The injury may consist of a dislocation where there is only ligament damage, allowing the two bones to separate. In more complex cases a fracture of one of the two bons may also be present.
Lisfranc's injury or Lisfranc's fracture-dislocation is rare in sport but if left untreated can have very severe consequences. If a case of midfoot sprain is suspected then Lisfranc's injury should also be considered.
The term Lisfranc's joint refers to the tarsometatarsal joints where the long bones (tarsals) in the foot meet the smaller bones (metatarsals) of the toes. Jaques Lisfranc was a surgeon in Napoleon's Army who described an operation for an amputation through this joint.
The most common cause of this injury is stepping into a small hole, which causes a strong twisting force with a lot of body weight on top. It can also happen in sports and car accidents.
What are the symptoms?
Midfoot pain with difficulty placing weight on the foot.
Some bone deformity, although this is not always the case.
Swelling on the top of the foot.
Tenderness on the joints.
Pressing the foot upwards into plantar flexion causes pain, especially if rotated at the same time.
Lisfranc's Fracture Dislocation Treatment
What can the athlete do for lisfrancs injury?
Go and see a doctor or sports medical professional
What can a doctor or medical professional do?
X-ray is required with the athlete in a weight bearing position. This injury is often missed even with an x-ray, so if the therapist suspects Lisfranc's injury and it is not obvious through X-ray then...
MRI or bone scan is required to confirm the diagnosis.
If confirmed a plaster cast with a toe plate extending under the toes is applied below the knee to immobilize the joint. Sometimes the bones require fixing with pins or wires.
Treatment will then depend on the severity of the injury. Precise anatomic reduction of the bones is required. If this is the case then the cast is usually on for 4 to 6 weeks.
After this time general foot and lower leg rehabilitation exercises are done to restore mobility, strength and proprioception.
http://www.sportsinjuryclinic.net/gallery/foot/lisfrancs180.jpg
What is Lisfranc's injury?
Lisfranc's ligament connects the medial cuneiform bone (one of the tarsals) to the base of the 2nd metatarsal. The injury may consist of a dislocation where there is only ligament damage, allowing the two bones to separate. In more complex cases a fracture of one of the two bons may also be present.
Lisfranc's injury or Lisfranc's fracture-dislocation is rare in sport but if left untreated can have very severe consequences. If a case of midfoot sprain is suspected then Lisfranc's injury should also be considered.
The term Lisfranc's joint refers to the tarsometatarsal joints where the long bones (tarsals) in the foot meet the smaller bones (metatarsals) of the toes. Jaques Lisfranc was a surgeon in Napoleon's Army who described an operation for an amputation through this joint.
The most common cause of this injury is stepping into a small hole, which causes a strong twisting force with a lot of body weight on top. It can also happen in sports and car accidents.
What are the symptoms?
Midfoot pain with difficulty placing weight on the foot.
Some bone deformity, although this is not always the case.
Swelling on the top of the foot.
Tenderness on the joints.
Pressing the foot upwards into plantar flexion causes pain, especially if rotated at the same time.
Lisfranc's Fracture Dislocation Treatment
What can the athlete do for lisfrancs injury?
Go and see a doctor or sports medical professional
What can a doctor or medical professional do?
X-ray is required with the athlete in a weight bearing position. This injury is often missed even with an x-ray, so if the therapist suspects Lisfranc's injury and it is not obvious through X-ray then...
MRI or bone scan is required to confirm the diagnosis.
If confirmed a plaster cast with a toe plate extending under the toes is applied below the knee to immobilize the joint. Sometimes the bones require fixing with pins or wires.
Treatment will then depend on the severity of the injury. Precise anatomic reduction of the bones is required. If this is the case then the cast is usually on for 4 to 6 weeks.
After this time general foot and lower leg rehabilitation exercises are done to restore mobility, strength and proprioception.
http://www.sportsinjuryclinic.net/gallery/foot/lisfrancs180.jpg
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