This is a fracture/injury of the ligaments and bones in the middle part of the foot. This occurs at the level of the metatarsal bones of the forefoot as they connect to the cuneiform bones of the midfoot. Torn ligaments, broken bones can occur during this injury also, it can involve more than one joint.
-Fall from height
-Associated with ankle sprain/fractures
-Tenderness at the midfoot
-Inability to walk
-Deformity that increases with walking
X-rays/CT/MRI scans may be performed to visualize the fractures and determine the mechanism of injury. This allows the surgeon to come up with a treatment plan
This is usually reserved for non-displaced stable fracture patterns with no subluxation/ligamentous injury. Conservative care includes Rest, Ice, Compression, elevation, Below the knee cast, and non-weight bearing to allow for bone healing. The cast and compression may also be done to allow for swelling to go down in preparation for surgical intervention.
For displaced fractures with ligamentous injury, surgical repair is warranted. Most lisfranc fractures are treated with ORIF. This allows for the ligament to heal. Primary open reduction internal fixation vs Fusion will depend on the extent of the injury.
NWB for 6 weeks in cast/boot. Then transition to regular shoe gear