Lisfranc Fracture Dislocation (Midfoot)

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Introduction

A Lisfranc fracture occurs in the bones of the midfoot.  The fracture results from dropping something heavy on the foot or twisting the foot during sports or in a car accident.  If you suspect you have a Lisfranc fracture, you should see your doctor right away for prompt treatment.  Some Lisfranc fractures can heal with casting and physical therapy.  Bones that have moved out of place typically require surgery. 
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Anatomy

The Lisfranc joint is located where the small bones of the midfoot (tarsals) and long bones of the forefoot (metatarsals) meet.  The Lisfranc joint adjusts and regulates the position of the forefoot based on the position of the hindfoot.
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Causes

Lisfranc fractures can occur if a heavy object is dropped on the foot or if the foot twists forcefully.  This can result from motor vehicle crashes and contact sports.  A bone in the joint may break or be forced from its position (dislocate).
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Symptoms

Lisfranc fractures can cause pain when you stand.  You may not be able to stand on your foot or walk.  Your foot may swell and bruise and appear deformed.  A Lisfranc fracture is commonly mistaken for a sprained foot.
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Diagnosis

It is important to contact your doctor to receive a correct diagnosis and treatment.  Untreated Lisfranc fractures can lead to foot deformities and foot problems in the future.  You should tell your doctor about your symptoms and the events leading up to your injury.

Your doctor will review your medical history and conduct an examination.  Imaging studies such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans are used to confirm the fracture location and identify dislocated bones.
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Treatment

The treatment that you receive depends on the extent and severity of your injury.  A combination of non-surgical treatments is used if the bones did not dislocate.  A cast is placed on the foot to keep it in the proper position while the fracture heals.  During this time, you will need to keep weight off your foot and walk with crutches.  When the cast is removed, physical therapists will teach you exercises to help you gain motion and strength.
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Surgery

Surgery is used to place dislocated bones in the correct position and stabilize fractures while they heal.  Surgical hardware, such as pins, screws, or wires, are placed during surgery to hold the bones in alignment.  You will wear a cast and use crutches for about six to eight weeks.  After the surgical hardware is removed, you will wear a rigid walking brace or shoe.  You may participate in physical therapy to help you move your foot and walk.
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Recovery

Recovery is individualized and depends on the extent of your condition and the treatment that you received.  It is common for arthritis to develop after a Lisfranc fracture, requiring additional treatment in the future. 
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Prevention

It is important to follow your doctor’s instructions for keeping weight off your foot or refraining from certain activities while your fracture heals.  You should perform your physical therapy exercises at home as instructed. 
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.