
Type of Procedure: Outpatient
Length of Procedure: 1-1.5 hour
Anesthesia: Regional nerve block with general anesthesia or sedation
Medications: Oxycodone or Norco for pain, aspirin 81 mg twice daily for 3 weeks to lower risk of blood clots, ondansetron for nausea
Follow-up appointments: 2 weeks, 6 weeks, 12 weeks
Time Non Weight Bearing: 6 weeks no weight, 4-6 weeks weight bearing in boot
Time to Driving: When off narcotics for left foot unless you have a clutch, 11-13 weeks for right foot
Lisfranc Injuries: General facts
- The Lisfranc (tarsometatarsal) joint is the joint that connects your midfoot to your forefoot
- The Lisfranc ligament is a strong ligament that connects your medial cuneiform bone to the base of the second metatarsal
- It is important in supporting the arch of your foot
- Injury to the Lisfranc ligament is usually caused by high energy accidents (falls from height or car accidents) or athletic injuries where the foot is pointing down and someone/something lands on the foot or heel
- Can involve one or many joints and is sometimes associated with fractures in the base of the metatarsals
- Diagnosis can often be made on weight bearing x-rays but sometimes more advanced imaging including MRI and CT scan are required to confirm the diagnosis
- If left untreated, there are high rates of collapse of the arch and development of severe arthritis of the midfoot
Treatment of Lisfranc Injuries
- If there is just a sprain to the Lisfranc ligament, a period of non weight bearing for 6 weeks in a boot is used
- If there is complete injury to the Lisfranc ligament or disruption of the Lisfranc joint, surgery is generally recommended
- Surgery typically involves an incision over the top of the foot
- The joint/s are aligned in the appropriate alignment and held with plates and/or screws
- The goal is to align the joints and allow your body to heal the ligament
- Usually, the plates and/or screws are removed in a second procedure 4-4.5 months after the initial surgery
Before Surgery:
- Elevate extremity
- Ice the affected ankle
- Do not put weight on the foot while in your boot
After Surgery:
- Immediately after:
- In splint below the knee (do not get splint wet)
- Elevate the leg, ice, take pain medication
- No weight (use crutches, walker, knee scooter, or wheelchair)
- 2 week appointment:
- Stitches come out and steri-strips placed
- Placed into boot
- Begin moving the ankle and toes on own at home
- May run soapy water down incisions but do not scrub or soak
- No weight allowed after this visit
- 6 week appointment:
- May begin placing weight on the foot in the boot
- Start physical therapy to work on strength and motion
- Can go into a swimming pool and use stationary bike (seated)
- 12 week appointment:
- Transition to a shoe with the help of physical therapist
- Continue working on range of motion and strength
- Avoid high impact activities including running and jumping
- Plan for removal of hardware at 4-4.5 months