JudoBill

Hi,

I just wanted to give an update on my experiences recovering from lisfranc surgery over the last four months. I initially found healthboards by doing a google search for lisfranc when I got my injury. I'm not sure how typical or atypical my experiences have been, but I thought it would be useful to describe the whole process for someone else who might be trying to learn about this injury and what to expect.

Injury- I am a 37yo male and I was hurt at the end of May while training for a judo tournament. I can't remember exactly how the injury was caused, but I think it happened when I stepped into my oppenent to do a throw. I was turning into the the throw, he stopped it and threw me. I think the combination of the twisting in my foot and the impact of his throw caused the injury (that's my best guess). On impact, my foot instantly was swollen (twice its size and it looked like a big football) and boy did it hurt!

Diagnosis- I went to the ER that evening, and after waiting many many hours, they finally X-rayed it and told me that it didn't look too serious, but that I should keep off it and see an orthopedist soon. I saw an orthopedist two days later and he did several rounds of x-rays before diagnosing the problem as a lisfranc dislocation. We warned me that the injury was "significant" (you never want to hear that word from your doctor unless it is followed by the word "improvement") and that I should have surgery within two weeks. I got a second opinion, and he agreed. I had the surgery 8 days later, allowing the swelling to subside a bit.

Post Surgery (nonweightbearing)- I had the surgery on June 1 and stayed in the hospital overnight. The doctor performed an open reduction with three screws to hold everything in place. Right after surgery, my foot was in a cast past my calf. I was told I could not bear any weight on it for about 8-12 weeks. At 2 1/2 weeks post surgery, he took the cast off and told me to continue non weightbearing. He also told me to rotate my ankles, spelling out the alphabet, and to try to bring my ankle up past 90 degrees (THAT WAS VERY IMPORTANT- it made walking much easier weeks later). In the beginning, I couldn't even rest my foot on the floor. While I didn't have any pain (except when I lowered my foot and the blood rushed into it), I did have a couple of spots that seemed very sensitive- I felt like I got an electrical charge when I brushed lightly against the spots. My doctor said that was normal, possibly scar tissue, and that, hopefully, it would go away on its own.

(weightbearing as tolerated)- at 8 weeks post surgery, the doctor said I was ready to start putting partial weight on my foot in a walking boot. He also told me to start physical therapy. Initially the foot was very sensitive, and if I put too much weight on it I got a sensation of pins and needles throughout the foot. The therapist got me to walk with one crutch and then with a cane. In about two weeks (10 weeks post) I was walking without the crutches. The physical therapy was mostly loosening the joints in the toes and the ankle (which get amazingly stiff from nonuse). At first, my toes didn't bend at all, but gradually they started to loosen up. I also had to bike and use bands and light weights for leg extensions, leg raises and ankle flexes.

(walking in shoes)- at 14 weeks post surgery, he took me out of the boot and told me to walk in shoes. I needed a wider shoe that was 1/2 size bigger, but I found some Rockports that felt ok. Over the next three weeks, the foot loosened up. Walking was still a bit uncomfortable, but after a couple of weeks I could walk at a normal pace, without a limp. He told me to keep walking and biking- absolutely no running (not that I could have even if I wanted to).

(removal of hardware)- at 18 weeks post surgery, he removed the three screws. It took about 20 minutes, and they knocked me out with general, but after about 1 hour, I was able to walk (very slowly) out of the hospital. I had to limit my activity for 48 hours after the removal, but 3 days later, I was able to go back to work and walk without a cane (although the cane made me feel more comfortable).

Today- my foot is still very stiff, especially when I first step on it, but it does loosen up as I walk. To strengthen it, I bike and walk as much as possible. The doctors says that in 2 months he thinks I might be ready to start running on it and getting back to judo. I hope he is right. I can't stand on it for long periods (I stood on it for 3 hours at a party a few weeks ago and I really regretted that!). However, I can walk on it all day and I don't feel that much worse at the end of the day. I still have aches and pains that pop up and go away, but, thankfully, nothing that has prevented me from walking. The spots where I felt that electrical sensation weeks ago are not as bad- it seems that it might have been scar tissue that is breaking up. There is still some swelling at the top of the foot- but I notice much less swelling since the screws have been removed.

I'll let you know how things develop over the next couple of months.