Lisfranc Fracture Dislocation

[amyg810]

I've been diagnosed with a lisfranc fracture dislocation in my right foot. The amount of displacement is only 2mm. I was offered surgery but the podiatrist I saw wasn't really convincing either way (you need the surgery vs. you can get away without it). I also have a fractured second metatarsal and fractured third metatarsal. I have no pain, have been non-weight bearing for almost 4 weeks. Weight bearing x-rays showed no shifting whatsoever.

My question is.... Has anyone had this problem? If so, any success stories out there in regards to non-surgical treatment? I'm beyond the window now where they can repair it surgically. I just have this nagging need to know whether or not I made the right decision. There is very little useful information out there. From what I have found, this sort of injury happens 1 in 55,000 foot fractures/ injuries. Most of the post-surgery stories I've seen were horror stories about chronic pain lasting months to years ending with bone fusion anyway. And it didn't help that I was expected to make the decision on the spot on whether or not I was going to have the surgery. Surgery would have meant 10-12 on crutches, plus who knows how much longer other treatments, partial or non-weight bearing, etc would have been required. With two kids at home, this didn't really seem do-able. Any help would be appreciated.
Thanks :)

[amyg810]

So, it's been a looooooong time since my injury. I'm pleased to say that I have very little pain. I ended up in a boot for two weeks, cast another two weeks, boot for 2 more. This first 6 weeks were on crutches, completely non-weight bearing. 6 more weeks in a boot, weight bearing, no crutches, but "taking it easy." All this time later the only thing I really notice is that by the end of the summer, I notice soreness more often from walking barefoot and with sandals. Also, when I take a step I notice there is a bigger gap between my first and second toe on my injured foot than on the other one. It's not painful, it just looks freaky. My ortho doc told me at the end of the twelve weeks of treatment that I most likely developed some very solid scar tissue that would hold things together. After reading about how bad a Lisfranc injury can be, I am thanking my lucky stars. I think because the displacement was so small I was able to get away without surgery. Other injuries might not be so lucky. I may still need some sort of surgery or bone fusion down the road, but it was my understanding that most of the time this injury ends in a bone fusion anyway. So as to not jinx myself, I still have my boot and the crutches. I think getting rid of them would be bad luck. Hope those with this injury find relief. :)

[lisfrancsuccess]

Go to an orthopedic surgeon, asap.  Lisfranc is not a "wait" type injury.  Success comes from immediate action.  I'm worried you missed your window now.  Hopefully, you only had/have a sprain. Good luck.  The biggest detriment to lisfranc success, is not dealing with it in the first 6 weeks, and that means surgery if it's a complete rupture, period... no alternates.

[Dr Vinod]

Hello!

The most important thing is to diagnose the dislocation properly. If the dislocation is less than 2 mm then it can be managed by casting and immobilization for 6 weeks.

You should completely rest and avoid any weight bearing during this period.

I would suggest you to take NSAIDs and if your symptoms continue and if conservative treatment fails consider surgery.

Take care!

[noodle20]

I am actually dealing with the same issue. I was diagnosed with the Lisfranc dislocation of my 1st metatrasal due to a gap seen on weight-bearing x-rays. The podiatrist wants to schedule me ASAP for surgery to put in screws but i think she is jumping the gun. I would like some opinions as well to help me decide what to do.