Hopefully some of you who have had a lisfranc injury are still looking in on these boards. Here's my story...
I stepped on something, rolling my foot, on 11/9. Went to the ER and was told I had a fractured 3rd metatarsal. I was given a boot and told no weight bearing until I followed up with an ortho doc on 11/11. Actually ended up seeing a physicians assistant that day who also found a fracture on my second metatarsal and suspected a Lisfranc fracture-dislocation. He sent me for a CT scan on 11/14. Followed up in the office on 11/18 (was actually forced to see a locum filling in for a week because nobody else was available). He said, yes, you do have a lisfranc injury but it is "borderline" as far as whether or not surgery is needed. He didn't feel comfortable making the call on whether or not I should have surgery so I was told to follow up the following week with the orthopedic surgeon regularly at the practice. The PA called me on 11/20 saying he needed to see me "that day." So, I went in and he said (again) yes, you have a lisfranc injury, but we are referring you to a podiatrist (2 hours from my home). Was told that I was running out of time to fix it surgically. Went to the podiatrist on 11/24 who told me that the displacement is 2mm (apparently GREATER than 2 mm surgery is a must). He wasn't convincing either way as far as whether or not I should have the surgery or not. Weight bearing x-rays showed no shifting at all. He told me he would use a clamp, not screws, to get it "as close as he could to normal." I would be on crutches for 10-12 weeks post surgery.
I opted not to have the surgery because after about the 15th I have not had any pain. The crutches have been the worst part of this injury and I need to get back on my feet for family reasons. Podiatrist put me in a cast (still non-weight bearing). Went to see the ortho doc here at home on 12/10. X-rays (non-weight bearing) showed no changes. Talked him into taking off the cast and letting me go back to the boot. I'm still non-weight bearing. My foot is half the size it was when I injured it so the boot doesn't fit right. I've been wrapping my foot in an ace bandage under the boot to keep it snug, which actually feels pretty good. I've noticed a little bit of soreness, but nothing I'd really call pain since going back to the boot. I go back to the ortho doc on monday 12/22 for more x-rays. That will be six weeks post injury. I am sooooo hoping he will let me start walking on it. But then again, I have no idea how long it takes a ligament to heal so who knows.
Anyway, that's my story. Hopefully it will have a relatively happy ending. I realize that by not having the surgery my foot may never be normal, but it seemed like the right decision. Anyone have any thoughts?
Back from my six-week check. More x-rays still showing no shifting. Thankfully, I was given the green light by the orthopedic surgeon to start walking on it. He said that since the displacement was only 2mm, I will most likely do just as well without having had the surgery, which was a huge relief. Of course, he's a guy that does mostly knees and carpal tunnel surgeries, but he's been around a while and I trust him. I'd been doubting my decision since I made it but I finally feel for certain that I did the right thing. I've been walking on it since last night (even did a little shopping). I was a little sore but it was nothing that a little advil couldn't take care of. Just having my mobility back is a huge boost. I go back in 3 weeks now for another set of x-rays to make sure it hasn't shifted with weight-bearing, probably a final x-ray 3 weeks after that. I've been instructed to wear the boot for another six weeks, but I don't care, I'll wear the boot till the fourth of July if it means not being on crutches.
Hope your Lisfranc heals well without the surgery. Sounds like it was damned if you do damned if you don't do the operation.
My story : fell 15+ feet off a ladder 3/22/08. ORIF a week later with 2 screws. had 5mm diastis. 12 weeks NWB 4 weeks boot . Hardware removed 7/22/08 (4 months post op)
Since this time my arch has collapsed. I cannot walk without some sort of pain. I cannot run or jump.
I am 35 years young. Prior to this injury I run the Boston marathon( twice ). Competed in 2 Toughman contests( winning one ) and have hiked the APP. trail.
My life has been turned upside down and Need it back.
The most Positive note is Living in BOSTON I have seen the 2 best Foot/ankle Orthos that New England has to offer. Both Suggested a 4 bone/3 joint fusion which should do the trick. I go under the knife on 12/29. Hell of a way to spend the new year.
I was told "by the best" that if the Lisfranc joint is disrupted even a little, that arthritis is in you future and that fusion is the mainstay for this injury.
Oh I forgot to mention that I was doing great on the foot until about 5months post op. Thats when it all started to fall appart for me. Hope other have better luck. I just hope this fusion will make me pain free.
Wow, I hope things get better for you. This is an insane injury. I just tell people when they ask what happened a non-specific "I broke my foot." When you start getting into all this lisfranc stuff they kinda tune out. I know this probably isn't going to make you feel any better, but post-surgery stories like yours is kind of why I pretty much decided not to have the surgery. The podiatrist I saw (in Concord NH) had told me either way I could end up with arthritis, either way I would need orthotics, and the surgery might not put the bone exactly back where it should be. "As close to normal" as he could wasn't good enough for me. So you're right, I was damned either way. Just didn't want to put myself through 3+ more months of hell with the surgery to have it not turn out right and end up getting a fusion anyway. This is my second day walking and I'm feeling ok. It is sore, but I think it's mostly all the parts of my foot that I haven't been using for the past six weeks. I really hope that the fusion helps and you're able to get back to your life. Best of luck to you next week. Oh, and Happy Holidays.
I did have the surgery, and am very glad that I did. After the initial injury, it was misdiagnosed as just a fracture. I was NWB for 6 weeks with a cast. After that I could walk, but it just never felt right. You could tell that something was wrong. So, I went to a orthopedic teaching professor that said I would need some surgery and it was diagnosed as a "lisfranc". You are right.....no one has any idea of what that is...including myself before I had one.
After surgery there were many hours of physical therapy. I can walk pretty good now, but I tire easily and I need to walk with lace up shoes. The doctor told me right from the beginning that I need to wear that kind of shoe for the rest of my life. I guess because you no longer have an arch, and you need the support. You may not be able to run any marathons, but be thankful that you can still walk and go on with your life. Look at the people out there that have it a lot worse than a lisfranc. I am so happy that I had the surgery, because I remember what it was like without it. Merry Christmas to all of you.
1 day until fusion. I was able to get the # of 2 people that my Dr. has preformed the same procedure on. Both were very pleased with the results( one ran a 5k road race). Still hope this does the trick. What a hell of an injury. I plan on Hiking Arcadia National park this summer and hope to do it pain free. Will update all after the surgery.
Hi there, i'm so glad to have found you guys, not that i would wish this horrific injury on my worst enemy. After reading other peoples stories i'm quite concerned that my treatment was a little fast. accident on the 22nd oct 08 involving a wet towel and stairs, not the best combination. Surgery on the 27th oct 08 involving 2 k wires and 6 screws. 6 weeks plaster, k wires out, screws out on 21st jan 08. had to beg for a boot for much needed support, and have a very deformed foot, which involves only being able to wear ugg boots, so many questions that no one can answer. Will i always have a limp? will my foot always be deformed? will the pain ever subside to a bearable level or will it at least get a little better after getting the screws out. Never thought that what i thought was a severely sprained ankle would turn out to be such a debilitating uphill struggle, but hey i suppose it could have been worse. good luck to you all.
My foot was deformed too. I had a 5MM Lisfranc injury in Mar 08. 12 weeks NWB 6 cast 6 boot. Then a wicked struggle to just keep from breaking down from the pain. I KNEW MORE WAS WRONG, or at least something was never fixed right.
The absolute best and only thing to due is find a FOOT and Ankle Ortho surgen that is well refered to and has intimate experiencr with Lisfranc.
I am on round 2 of surgery. I had 3 joints fused on DEC> 29th.
Yesturday I had the dressing removed and the cast put on. I had about 10min. to look at my foot during the cast time. I have my arch back, my foot is straight as an arrow and my first Met is lower then the rest of the toes( this is normal) all of this I did not have before. I am very excited at this piont and cannot wait to try it out (6more weeks)
I am told I should be able to run and be about 90%. I was about 50% before and could not walk without pain for 8 months.
I Found " the Best" Foot ortho in New England. He gave me Phone #' of others who were in my shoes and they are now very happy. You do not loose mush at all with a midfoot fusion. I'm told to get ready to play soccer in the summer. I'll check back to see if you want to talk. Just listen to the Dr.s for now. Thats all you can do.
My foot was deformed too. I had a 5MM Lisfranc injury in Mar 08. 12 weeks NWB 6 cast 6 boot. Then a wicked struggle to just keep from breaking down from the pain. I KNEW MORE WAS WRONG, or at least something was never fixed right.
The absolute best and only thing to due is find a FOOT and Ankle Ortho surgen that is well refered to and has intimate experiencr with Lisfranc.
I am on round 2 of surgery. I had 3 joints fused on DEC> 29th.
Yesturday I had the dressing removed and the cast put on. I had about 10min. to look at my foot during the cast time. I have my arch back, my foot is straight as an arrow and my first Met is lower then the rest of the toes( this is normal) all of this I did not have before. I am very excited at this piont and cannot wait to try it out (6more weeks)
I am told I should be able to run and be about 90%. I was about 50% before and could not walk without pain for 8 months.
I Found " the Best" Foot ortho in New England. He gave me Phone #' of others who were in my shoes and they are now very happy. You do not loose mush at all with a midfoot fusion. I'm told to get ready to play soccer in the summer. I'll check back to see if you want to talk. Just listen to the Dr.s for now. Thats all you can do.
thanx for your reply, can i ask how your foot felt 11/12 weeks after surgery, some doctors say the lump on the top of my foot is a swelling and others say it will stay there. i cannot launch into a step as the pain is too much. maybe its early days and i'm being optimistic, my screws come out on the 21st jan, i'm hoping maybe it will make a difference.
I cannot really answer that ? well. I was still NWB at the 12 week mark. My screws came out at the 4 month mark post surgery. I only had 2 screws at that time.
I am assuming that the wires are in the 4th and 5th met. and the screws are in the first 3 mets. The 4 and 5 have the most motion so they do not want to screw them.
All I can say is that you should listed to the dr.s, but you also have the right and obligation to question them. Any Dr. worth his or her salt will not mind ?'s and should welcome them.
The lump I had at the arch of my foot was the first met and cuneiform sinking down due to loss of arch due to the Lisfranc joint area loosing its spacing. The Dr. raised my arch by pushing up th first met and cuneiform before fusing them together.
I originally thought I would come out of my first surgery fine( I only had 2 screws and displaced the 2nd met only) but what Ive come to learn is that a completely torn ligament is the worst and should require fusion in the first place. It wont heal enough to hold an active lifestyle.
Please hang in there and let me know what the Doc says.
I haven't checked back here for awhile, and I am sorry to hear that some of you are still battling and others are just begining this long process with Lisfranc.
I fell on the sidewalk on 5/19/08 while lifting my 5 yr old and tripped. Both of our body weight went down on my foot which had twisted to the side. I had immidate intense pain, swelling, and bruising on top and under my arch.
misdiagnosed 1 week later as Lisfranc without a need for surgery. Fracture dislocation of the 1 & 2 metas. Pain stopped after 2 weeks but still felt something was very wrong with my foot and did not want to put any weight on it.Second opinion at UCLA needed surgery right away. That was on 6/19/08. 12 weeks NWB in cast, 6 wks more in boot.
I am now 8 months post surgery, with the same 3 screws still in. No plans to remove them unless there is a problem. I have no pain and can do my daily activities, and only become tired after 2 hrs of walking. I was horrible about going to PT so I didn't give my foot a fair chance to heal and the ankle tends to be stiff. Actually my ankle gives more trouble than my foot! But I'm happy so far and thankful that I am at least 90% back to normal.
hi deano. only a few days away from having pins removed, still cant make a full day without some pretty strong meds, also a severe limp i find it much easier to walk with the boot, but the doc recomends i use it as little as possible i think the fear of full weightbearing while the screws are in is also hindering my progress although the pain would be intolerable. I'm still very optimistic about the outcome and i'm back at work, which fortunately does'nt involve alot of walking. will keep you posted on post op. thanx again nicky.
Still walking on it, still in the boot, still doin ok. My x-rays last week still showed no shifting whatsoever so I guess it healed as well as it could have. My next visit will be in two weeks. The doc told me no more x-rays (YAY!) and that he'll probably turn me loose after that. I've been having a little soreness but nothing where the injury was. I think it's just my foot getting used to bearing weight again. I've taken a few steps without the boot on and I have absolutely no flexibility in my ankle. Of course, at this point, it's been immobilized with my foot for 10 weeks. When I take the boot off at night I've been rotating my foot to try to get my ankle moving again. I've heard that trying to write the alphabet with your foot is a good exercise. Maybe I'll eventually try that.
Dean... I hope your fusion is healing well. And I wish all the best to the rest of you
Hello unfortunate others. I have been reading the messages on this board and decided to join and askk some questions. I fell approximately 4 feet from a ladder while staining my children's playset on 9-26-08. An external fixator was placed on 9-27-08. I had an ORIF with plate and screw insertion on 10-14-08 after some of the swelling subsided. The 1st and 2nd metatarsals were fractured and all 5 metatarsals dislocated. My foot was not a pretty site. The nonweightbearing period was almost unbearable but I made it through and started full weightbearing on 1/2/09. I am wearing running shoes and able to walk with very minimal discomfort. I have a slight limp as it seems my foot doesn't bend like it used to. I am able to do everything at home like normal...except going down stairs which I take one step at a time like my 2-year-old...again the foot just doesn't bend like it used to. I'm hoping to be able to return to work as a RN. I will be devastated if unable to. I am able to go out shopping still with minimal discomfort. The only thing I notice is it feels like the 5th metatarsal rubs the bottom of my shoe a bit and it almost looks like the cuboid bone is shifted over a bit but again not much discomfort. Is there anyone out there that was able to get back to normal things and go back to work and if so, how long did it take? Any responses are greatly appreciated.
the big ? is did you have any of the bones fused. I only dislocated the second met. last April and had ORIF 2 screws( No fusion ) and could not walk without pain. I went and saw a different Dr. and he fused my first and 2nd met on 12/29/08. I am in a boot now after 7 weeks NWB and I feel great. I hope yours works out better then mine, but be on the lookout for midfoot Arthritis. Its a killer pain. By the way I am 35 years young. Not over weight and very fit. I can handle a lot of pain, but that was unreal.
Everyones injury is different. Hope yours is one of the success stories. I'll let you all know how mine goes when I get back into shoes.
No, no fusion. The Dr. hopes or hoped that the first met would auto fuse. I had a plate and screws placed to mets 1-2 and pins to mets 3-5. I'm walking with almost no pain...just a little discomfort since my foot seems a little wider. What should I look for when/if the arthritis sets in? How long does that normally take? Does anyone do well after this horrible injury? I'm only 33 years-old with an 8-year-old and a 2-year-old and hope that I'm not miserable with this the rest of my life! Were you able to go back to work since the start of your injury or have you been off since? I go back to the Dr. on Thursday and hope to be released to do at least 4-hour shifts since I normally work 12-hour shifts. My surgery was on Oct. 14th and I've been full weight bearing in my running shoes since Jan. 2nd and definitely notice some improvement. My foot killed me for about the first week since I had to get everything stretched out again...it almost felt like plantar fascitis but that is gone now. Thanks for your imput and keep me posted on your progress.
Last edited by lameleftfoot; 02-08-2009 at 07:55 PM.
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Well I get my hard cast off on 2/24/09 on round 2 of this weird horrific injury. Foot is still quite a bit swollen, but I remember that the swelling does not really go down until you start to use the foot again. I have read and been incontact with some fellow fused foot folks and I'm looking forward to a life with no more arthritis and foot pain. A stiff foot and about 90% is fine with me. I've come along way since running the Boston Marathon on 4/14/07. Let me know how you all are progressing.
Well, I've been out of the boot for almost two weeks. It definitely feels wierd to be wearing shoes again. My foot has been a little sore on the top of it, but no unbearable pain. I'm still limping quite a bit, especially by the end of the day but it's more of a flexibility issue I think. Doc told me to give it a week or two and if I wanted to try therapy he would send me. I think I'm gonna be ok tho. He was pushing and moving the bones on my last appt, no pain at all. He seems to think I developed some good solid scar tissue that is keeping everything in place. I'm still taking it easy on it for now. Good luck to all !
I went to Dr. yesterday and he was pleased. He said nothing has moved since full weight bearing over the last 6 weeks and that all looks good. I am returning to work tommorrow for 4-hour shifts for a couple of weeks and then 8-hour shifts for awhile working up to 12-hour shifts. My foot swells a bit on the lateral side and ankle but otherwise looks pretty good. I have a mild limp and I don't walk as fast as I used to but I figure that will come in time! I'm just impatient! The Dr. thought the first met/cuneiform has probably autofused or is in the process of doing so. The plate connects the two of them. Keep me updated as it sounds like all is going well...let's keep it that way!
