All About Lisfranc Injuries: Risk Factors, Symptoms, and Treatment Options

If your foot is hurting, swollen, and bruised, you may have suffered a Lisfranc injury. Find out what it is, how it happens, and how to fix it.

In the 1800s, a French surgeon in Napoleon's army noticed many midfoot injuries among the cavalry soldiers. Over time, this fracture pattern became known as a Lisfranc injury after the name of the surgeon: Jacques Lisfranc de St. Martin.

Today, a Lisfranc injury is still a serious issue, although it’s relatively uncommon: It affects about 1 in 55,000 people in the United States (0.2% of all broken bones).

At Austin Foot & Ankle Institute in Austin and Cedar Park, Texas, we specialize in treating Lisfranc injuries to help our patients return to their regular activities. Here’s what you need to know about this injury.

Risk factors

Your Lisfranc joint on top of your foot is where your metatarsal bones (which extend to your toes) connect to the rest of your foot. It’s a complicated part of your foot: Many ligaments and tendons are also present to hold the shape of your arch and help your foot move properly.

A Lisfranc injury occurs when one or more bones fracture or ligaments tear. It’s a serious injury because the Lisfranc joint is so important to your ability to walk and move. Any damage can impact your quality of life.

Men in their 30s and athletes are most likely to develop a Lisfranc injury, but it can affect anyone who experiences sudden trauma to the foot.

The biggest risk factors include playing sports such as soccer or football (your feet are vulnerable to being stepped on or twisted), running frequently (the repetitive stress can cause problems), or having a condition such as diabetes or nerve damage that limits feeling in the foot.

Symptoms

Symptoms of a Lisfranc injury include pain on or near the top of your foot, swelling of your instep, bruising on the side or bottom of your foot, and difficulty putting weight on your foot, especially if crutches are required.

Diagnosis of a Lisfranc injury includes a physical exam of your foot and imaging tests such as an X-ray or MRI.

Treatment

Treatment depends on the nature and severity of your injury. If you don’t have a fracture, and the ligaments aren’t torn badly, you wear a cast or boot for 6-8 weeks to reduce stress on your foot, hold it in place, and help keep your weight off it while the foot heals.

If the bones and ligaments are more severely damaged or have moved too far out of place, you may need surgery to repair the damage.

Our board-certified orthopedic surgeons, Pedro Cosculluela, MD, and Andrew Ebert, MD, insert pins, plates, or screws as necessary to hold your bones and tissues together as they heal. You wear a cast or boot while your foot heals.

In either case, you need physical therapy to rebuild strength and mobility when you come out of the cast.

If you suspect a Lisfranc injury, our team is happy to help — we complete more than 20 Lisfranc procedures each year. To request an appointment, call one of our three Austin-area offices or request your appointment online today.