Lisfranc Fracture/Dislocation Surgery

Surgery is recommended for all injuries with a fracture in the joints of the midfoot or with abnormal positioning (subluxation) of the joints. The goal of surgical treatment is to realign the joints and return the broken (fractured) bone fragments to a normal position.

Internal fixation. In this procedure, the bones are positioned correctly (reduced) and held in place with plates or screws. Because the plates or screws will be placed across joints that normally have some motion, some or all of this hardware may be removed at a later date. This can vary from 3 to 5 months after surgery, and is at the surgeon’s discretion.

Occasionally, the hardware may break before it is removed. This is not unusual when screws or plates span bones that have some movement. Metal can fatigue and fail under these conditions, just as a paperclip will fail if bent repeatedly. Most often surgery is successful even if some of the hardware fails.

Fusion. If the injury is severe and has damage that cannot be repaired, fusion may be recommended as the initial surgical procedure. A fusion is essentially a “welding” process. The basic idea is to fuse together the damaged bones so that they heal into a single, solid piece.

Lisfranc injuries that may require fusion include joints that cannot be repaired with screws or plates or when the ligaments are severely ruptured. The hardware will not need to be removed because the joints are fused and will not move after they heal.

Rehabilitation. After either surgery (reduction or fusion), a period of nonweightbearing for 6 to 8 weeks is recommended in a cast or cast boot. Weightbearing is started while the patient is in the boot if the x-rays look appropriate after 6 to 8 weeks. The amount of weight a patient can put on their foot, as well as the distance the patient is allowed to walk, is at the surgeon’s discretion. Impact activities, such as running and jumping, should be avoided until the hardware has been removed.

Your Doctors

Tips for Healthy Feet

  • Don’t ignore foot pain, it isn’t normal. If pain persists, see a physician.
  • Inspect your feet regularly. Note changes in color and temperature, thickness or discoloration of nails, and cracks or cuts in the skin. Peeling or scaling on the soles could indicate athlete’s foot. Any growth on the foot is not considered normal.
  • Wash your feet regularly, especially between the toes. Be sure to dry them completely.
  • Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. People with diabetes, poor circulation, or heart problems are more prone to infection and should not treat their own feet.
  • Make sure that your shoes fit properly. Replace worn-out shoes as soon as possible, and try on new shoes later in the day when feet tend to be at their largest.
  • Select and wear the right shoe for your activity, in other words, running shoes for running.
  • Don’t wear the same pair of shoes every day, but rather alternate them.
  • Avoid walking barefoot. Your feet are more prone to injury and infection when walking barefoot. When at the beach or wearing sandals, remember to use sunscreen on your feet as well as the rest of your body.
  • Use home remedies cautiously. Self-treatment often turns a minor injury into a major foot problem. If you have diabetes, it is essential that you see a podiatric physician at least once a year for a thorough check-up.