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Old 09-14-2007, 10:02 AM   #1
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Lisfranc - weight bearing?

I had a severe lisfranc fracture on July 11, 2007. Nine weeks later I am still in a cast. The five pins the surgeon used to realign my foot were removed five weeks after the surgery; one screw remains which will be permanent. I am not experiencing any pain (other than some swelling in the cast if I crutch around a lot during the day). In two weeks I will see my Doctor and I think he will put me in a walking cast. I can't wait to start putting some weight on my foot again, although after reading many of the entries on this message board I am concerned that once I start using my foot is when the pain will begin.

I am optomistic that I will have a good recovery, but also very concerned with the prognosis and average recovery after this type of injury. I am an active person that loves to hike and backpack. If you have any words of wisdom or if you are currently going through this, please respond to this post. It would be nice to talk with someone who has been there or is there.

 
Old 09-14-2007, 11:14 AM   #2
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Re: Lisfranc - weight bearing?

Hey you can read some of my posts to others about weight bearing.... I hope it helps I had a bunion procedure done....

 
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Old 09-15-2007, 03:49 AM   #3
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Re: Lisfranc - weight bearing?

I don't know a great deal about lisfranc fractures, but I am recovering from a 5th metatarsal fracture that happened in March of this year. I was in a cast for 15 weeks and when finally put in a walking boot and given permission to weight bear. it was surprising easy for me and painfree at the fracture site. What did hurt was my heel and that was relatively mild. It got much better the more I put weight on it. I think if you follow your doc's directions and slowly begin, the better you will be. I was told that if the pain was at the fracture site, to stop and wait two days before trying again. Luckily, that did not happen.
As with most metatarsal fractures, the risk of refracture is there (that is why you have screws put in) for people who are active. I was told my foot will not be back to normal for 12-18 months after I broke it and for that time, I need to be careful about the activities I do. I wear my walking boot anytime I am walking on any surface that is uneven or doing anything strenuous on my feet. Good luck and keep us posted.

 
Old 09-15-2007, 06:32 PM   #4
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Re: Lisfranc - weight bearing?

Thanks for the feedback and advise.

My next Dr's appointment is September 26. Once I start putting weight on my foot, I'll add another reply to report how it's going.

 
Old 09-16-2007, 10:11 PM   #5
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Re: Lisfranc - weight bearing?

Sounds like July 11 was a bad day - I also suffered a Lisfranc fracture the same day.

After a missed diagnosis, I finally ended up having surgery on 8/14. I received 2 screws, with the intention that they will not be removed. My hard cast came off after 1 week, and I was put back into a walking-boot (that I received at the time of the missed diagnosis as a foot sprain) to be used as protection. I've been on crutches since the surgery, definitely no weight bearing on the foot/boot. Actually, I received an "I walk free" crutch last week - such a nice device! It just took awhile to get it.

My next appt is also on 9/26. I might be able to use the walking boot as designed, and ditch the crutches if xrays indicate that everything's okay.

Since the hard cast was taken off, I've been free to take off my boot and manipulate/stretch my foot - as long as I don't put weight on it. Is this your case too?

My big concern has been my Dr's opinion that the screws don't need to be removed. I'm worried about metal fatigue - and what happens if one of them ever snaps? Perhaps it's an unfounded worry - but it's there.

 
Old 09-17-2007, 06:19 AM   #6
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Re: Lisfranc - weight bearing?

Hi RBall Player,

If your user name means racquet ball player, not only did we suffer our injury's on the same day, they happened in the same place. I hurt my foot in a racquetball court, playing walleyball. I did a search for "I walk free crutch", it looks like a major improvement over standard crutches.

I am still in a hard cast. A walking cast that can be removed for foot stretching and manipulation (not to mention a shower), will be a welcome change. Hopefully on 9/26, I'll be in a removable walking cast.

Good Luck and keep me posted on your progress.

 
Old 09-17-2007, 10:05 AM   #7
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Re: Lisfranc - weight bearing?

Yep, playing did it playing racquetball. (Mental note to self: stay away from rball courts on July 11). I am (refuse to say "was") a competitive rball player, and being away from the courts is slowly killing me. First tourney of the season was last weekend, and I was stuck at home watching my Seahawks choke it up instead of playing.

Yes, getting the cast off and being able to take a shower was a minor victory. I hope it is one of many to come. Not having the cast on has allowed me to see the atrophy in my leg. My calf was visibly smaller just 2 weeks post-surgery. Now I can see a difference in my quad just above my knee. However, I started working out with weights a couple weeks ago, and being able to take off the boot has allowed me to do a couple quad/hamstring exercises, as long as I don't put any weight on the foot itself. There is nothing I can do (to my knowledge, anyway) to exercise the calf.

The I walk free is great, as long as you don't have to stand up/sit down repeatedly - as it really needs to be completely removed in order to sit. It only takes a few seconds to put on/take off - but I plan my actions to make sure I get any/all tasks done while upright, before sitting down again. Being able to use my hands and carry things again is great, and I would recommend it to anyone that must be NWB on their foot or lower leg. I just wish I could have gotten it sooner. My Dr. didn't know it existed, but once I described it to him he thought it was a great idea and wrote me a prescription for it.

As of right now, I really don't wear the boot around the house. It doesn't fit the IWF very well, and that is what I use at home. If I leave the house, I have the boot on and leave the IWF at home.

 
Old 09-17-2007, 01:42 PM   #8
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Re: Lisfranc - weight bearing?

I like your attitude regarding playing competitive racquetball. I too am refusing to say "was" when it comes to the activities that make me happy. I set a goal for myself to climb Mt. Katahdin (the tallest mountain in Maine) next summer as a symbolic victory. I hope I can pull it off. I plan to work my butt off to make it happen (if I need to).

The atrophy in my leg is very visible even in my cast. Every other week they change my cast. It has gotten to the point where the circumference of the cast where my calf is, is the same size as the circumference of my calf on my good leg without the cast. My quad is also shrinking (although not as bad). As soon as I can start exercising my leg, I will. That is a good idea to do leg extensions and curls for your quad and hamstring. To try and stay a little active after this happened I brushed the dust off my weights so I can excercise at home, but I have only been working my upper body. I asked my doctor if there was a way to exercise my calf and he said without putting weight on your foot you can't exercise your calf.

 
Old 09-26-2007, 03:40 PM   #9
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Re: Lisfranc - weight bearing?

Had appt today, x-rays were taken - everything's is lined up the way it's supposed to be and looks good!

I've been cleared to start weight bearing in my walking boot. Need to start slowly, using crutches to assist: limited to 25% of body weight on the foot/boot at first, then 50%, 75% & 100% - could/should/might take a week to work up to 100%.

I've been cleared to drive, once I reach 100% (my right foot was the injured one). Rehab to start now, still have to make first appt - but have been told the first session will be an hour long.

Four weeks in the walking boot, then I should be able to start wearing tennis shoes again. Dr. didn't think I'd need orthotics (as I didn't wear them pre-injury), but said I could get off-the-shelf ones if I wanted to.

Next appt to be scheduled 6 weeks from now.



Everything went pretty much as I'd expected/hoped it would.

Loco - how'd your appt go?

 
Old 09-27-2007, 05:10 PM   #10
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Re: Lisfranc - weight bearing?

RBall Player - I'm glad to hear that your Dr's appointment went so well.

So far, so good for me too. I am in a removable walking cast. A shower after 11 weeks felt too good for words.

Day two of weight bearing on my injured foot - if I apply 50% of my weight on my foot there is essentially no pain. 75% some discomfort, but tolerable. 75% or greater is painful. I am pleased with these results at this stage in my recovery. I got a little overzealous while testing my foot, and now my foot is sore and swollen.

No surprises with my x-rays. There is a 1 mm gap at my 1st metatarsal. This has been the case since post surgery. I am a little concerned about this but at the time of the injury it was nearly an inch out of place. Other than that everything is lined up.

Next Dr's appointment in 4 weeks. My doctor told me to "Let the pain guide me" and to ease off the crutches. I hope to walk into my doctors office crutch free at my next appointment.

I'll start PT after my next Dr's Appointment. There will likely be an orthodic in my future (no big deal). Possibly a second surgery to fuse bones (but that is a last resort and hopefully won't be necessary).

By the way - this past weekend I hiked (crutched) a short section of the Appalacian Trail to reach a lookout overlooking Nahmakanta Lake in Maine. It was only a two mile hike (round trip) with a 200' elevation gain. Reaching the lookout with one foot in a hard cast (non weight bearing) was a minor victory and quite a surprise to the through-hikers that I met.

Like I said earlier - So Far So Good!

 
Old 09-28-2007, 10:10 AM   #11
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Re: Lisfranc - weight bearing?

Congrats on the progress!

The estimated week needed to wean myself off the crutches actually turned into a little under 24 hours. I was at about 50% right away, and at 100% the next morning without much pain at all - a little twinge with my first step sometimes, but the 2nd step is usually pain-free.

I went 2+ weeks from the time of my injury before I was diagnosed with the Lisfranc, during which I was wearing the walking boot (to support my "foot sprain"). I even transitioned to a regular tennis shoe for a little while. My foot now feels better than it ever did then. I'm still taking it slow for now, but I'm very optimistic at this point.

During my appt, I told the Dr. that my only issue was with with foot being swollen: When I wake up in the morning, my bad foot looked very similar to the good foot...until I become vertical, that is. Within 20 seconds, my bad foot swells up.

He explained that the lack of walking on it is a big cause of the swelling (besides the healing), and that the act of putting weight on the foot actually works to pump fluids back up the leg. As I start walk on it more, the swelling should go continue to go down. I think that has something to do with my first-step twinge, being caused by pressures related to swelling.

I was at the rball courts last night, just keeping in touch with the "regulars". I behaved myself and didn't take my racquet out of my bag...yet. However, I am already checking out the tournaments scheduled after the beginning of the year. Perhaps I'm optimistic...I'd rather think of it as getting prepared.

 
Old 09-29-2007, 10:45 AM   #12
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Re: Lisfranc - weight bearing?

RBall Player - You are an inspiration to the rest of us recovering from an injury to our Lisfranc ligament! Keep up your positive attitude and determination and I am confident that soon you will once again be competing in racquetball tournaments.

The morning of day three of applying weight to my injured foot I was down to one crutch and by that afternoon I was crutch free! This is not to say that it was pain free to go crutch free (a 2 or 3 on a scale of 10). I pushed through the pain until the evening when it had reached a 4. The swelling was not as bad as the previous day, but my foot was quite sore even while resting. I thought I might have pushed it too hard and that I was going to pay for it today.

Today (day 4) when I got up I started with one crutch, but quickly ditched it. I even took my 2 year old son out in the backyard to play on the playset. The playset has a small climbing wall that leads to a platform and slide. I was climbing up the wall and sliding down the slide crutch free with little to no pain!

To anyone out there reading this who has had an unfortunate event in their life that led to a lisfranc injury. Remember that there is lots of hope. My injury was very severe - a divergent class C lisfranc fracture, meaning that all five metatarsal were dislocated and they went in different directions. The surgeon told me that my injury on a scale of 1 to 10 was an 11. Going into surgery the doctors were concerned about the distal pulse in my foot and that there might be tissue death leading to partial amputation. Eeeeekk! Fortunately that didn't happen.

The only reason I am describing the extent of my injury is that I have found many depressing entries on message boards regarding lisfranc injuries even though there are many success stories. I plan on being one of those success stories and you can too. I don't know if my foot will ever be what it was prior to my injury, but at this point I am full of hope. I know that whatever happens it will not prevent me from doing the things that bring me pleasure in life. It's possible that I will do them a little different, but I'll still do them.

Other success stories. I spoke to one person that suffered a lisfranc injury while wrestling - this year he ran a marathon! I also met someone that had a lisfranc injury (she still has two permanent screws). She was wearing flipflops and proudly stood on one foot to demonstrate that she could!

Last edited by Locofoot; 09-29-2007 at 05:03 PM.

 
Old 10-01-2007, 06:36 PM   #13
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Re: Lisfranc - weight bearing?

i sufferd a lisfrancs dislocation to my right foot while in a wrestling match at old dimminion university it happend on a monday i was rushed to the hospital and it was miss diagnosed as a foot sprain and i was a refferd to a podiatrist when i got there he told me i needed to have surgery on that friday i had three screws placed in my foot to realign my first and second metatarsal i was then strict non weight bearing for time frame the date of my injury was june 18th i opted to have the screws removed on august 24 and i was non wieght bearing tell sept 14th i then was placed in a walking boot tell sept 26th i am now going threw phisical therapy 3 times a week walking and starting to jog the key to getting threw this injury is knowing your limits and having the will to move on i plan on wrestling next year i cannot this year becuase my right foot dosent have the strenght it needs yet to return to folkstyle wrestling but as i said the key to making it threw this injury is determanation looking ahead and cherishing every step you take when my injury happend the said i would never run agian well im 15 weeks post op and i am running its not a perfect run but its sure a start but my advice to any one that suffers this injury listen to your doctor this injury is severly truamatic and if you dont listen it will re accure again oh btw some may think this only happens when your older


im a 16 year old high school atheleet that was at a off season training camp at the very begining of summer this injury is severe but if you have the will to make it you will

so all that have had this injury i feel your pain but it will get better but only you can make it better threw hard work do not give up or this injury will cripple you

 
Old 10-02-2007, 08:26 AM   #14
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Re: Lisfranc - weight bearing?

York wrestler - Thanks for the reply.

I think your approach (will power, hard work, and determination) will not only get you past this injury. It will help you become a better wrestler and succeed in life.

Keep it up!

Last edited by Locofoot; 10-02-2007 at 10:07 AM. Reason: spelling

 
Old 10-02-2007, 06:49 PM   #15
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Re: Lisfranc - weight bearing?

thanks locco it was really hard but im going do to anything to beat this injury i want to return to wrestling my senior year

 
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