A Lisfranc fracture is a type of broken foot. Like all fractures, the treatments you’ll need and your recovery time will depend on the severity of your original injury. You might need surgery. Most people need to wear a cast or boot for six to 12 weeks, and it can take a year or more to return to intense exercise like running.
A Lisfranc fracture is a type of broken foot. The Lisfranc joint is the spot on top of your foot where the metatarsal bones (the bridges to your toes) connect to the rest of your foot.
This is a complicated area of your foot. It’s where many bones, ligaments and tendons all come together to hold your foot’s arch in shape and help it move properly. Because so many parts of your foot meet up in one place, the Lisfranc joint is very important. It’s just like a busy highway on-ramp or main intersection in a city: A lot depends on a relatively small area to make everything work correctly.
You can hurt any part of your Lisfranc joint. Lisfranc injuries are most commonly caused by an accident or some kind of trauma. Athletes can injure their Lisfranc joint playing sports, but even a small stumble or tripping throughout your day can cause an injury. Major traumas like car accidents and falling off a ladder also cause Lisfranc fractures and injuries. If you have a fracture, you broke at least one bone, but you can also tear or sprain any of the joint’s connective tissues.
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A Lisfranc injury isn’t life threatening, but is still very serious. Because the Lisfranc joint is so important to your ability to walk, run or move, breaking any of the bones in it — or injuring any of the ligaments and tendons supporting it — can have a big impact on your quality of life.
You need to get your injury examined by a healthcare provider as soon as possible. This will ensure you know exactly what’s wrong and which treatments will help you heal.
Like any bone fracture, the severity of the original injury and any damage done to your bones makes each Lisfranc injury unique.
Lisfranc injuries are relatively uncommon, but that might be because many people never get them officially or correctly diagnosed. In fact, experts estimate that up to 20% of Lisfranc injuries are missed or misdiagnosed when people visit emergency rooms with foot pain. That’s why it’s important to give your provider all the information you can about your injury. The more they know about what you’re feeling and how you got hurt, the sooner they can arrive at the right solutions for you.
Lisfranc fractures are only 0.2% of all reported broken bones. Only 1 out of every 55,000 people in the U.S. is diagnosed with one per year.
Lisfranc injuries and fractures can happen to anyone because they’re caused suddenly and by trauma. There’s no clear road map of who is more likely to experience a Lisfranc injury, but certain activities and health issues might slightly increase your risk:
Men in their 30s and athletes tend to be the most common people to get Lisfranc fractures.
If you’re diagnosed with a Lisfranc injury or fracture, you’ll be unable to put weight on your injured foot for several weeks. Exactly how long depends on what is hurt or broken. Expect to wear a boot or cast that will prevent you from putting weight on your injured foot for at least six weeks.
If it’s not treated properly, a Lisfranc injury can lead to serious complications, including:
Lisfranc injuries — whether or not you have a fracture — often have the following symptoms on or near the top of your foot:
Your injured foot might look different than usual. Look for bruising or any discoloration on the top of your foot and on your foot’s sole. If possible, compare it to your uninjured foot. If something looks different or out of the ordinary, get your foot examined, especially if you’re in pain or can’t walk or move like you usually can.
Lisfranc injuries are almost always caused by a fall, slip or trauma to the foot. You might read about “direct” (high energy) and “indirect” (low energy) causes of Lisfranc injuries. These are different ways to help your provider understand the specifics of your injury. Direct causes are traumas that crush the Lisfranc joint, like car accidents or something falling on your foot at a worksite. Indirect causes are much more common and come from slips, falls and sports injuries. Anything that makes your heel unexpectedly twist or spin while you’re stepping with weight on the ball of your foot can injure your Lisfranc joint or fracture the small bones in it.
What you were doing when you injured your foot is often the best way for your provider to correctly identify and diagnose a Lisfranc fracture or injury. Make sure you share as much as you can about what led to your foot’s injury or what you were doing before you noticed symptoms like pain or bruising.
A Lisfranc fracture is diagnosed with a few steps:
Your provider needs to know what caused your injury to correctly identify and diagnose a Lisfranc fracture or injury. It’s extremely important they know as much as possible, so make sure you share as much as you can about what you were doing before you noticed pain, bruising or other symptoms. Because even little slips or stumbles can cause a Lisfranc injury, the more details you can share the better — including how your foot was positioned when it was injured.
Your provider will examine your foot and compare it to your other, uninjured foot (if possible). They will also examine the injured or painful area and check its shape and stability.
After a physical exam, you’ll likely need at least one of a few imaging tests to take pictures of your foot:
Your treatment will depend on your specific injury, and whether or not you have any broken bones. You might need surgery. Most people wear a cast or boot for six to 12 weeks, and it can take a year or more to return to intense exercise like running or playing sports.
If you don’t have a Lisfranc fracture — or if your broken bones are not too far out of place — and your ligaments aren’t too damaged, your provider will put your injured foot in a boot or cast. This will reduce stress on your hurt foot, hold it in place and keep you from putting weight on it. You’ll also likely need to elevate your foot as often as you can, especially right after your injury. You might also need to use crutches to make sure you can’t put weight on the injured foot.
Six to eight weeks later, your provider will check your progress, often with follow-up X-rays. If your Lisfranc injury has healed well enough and you’re no longer experiencing pain, you should be able to put some weight back on your foot as part of a physical therapy plan.
You will likely need surgery if the bones and ligaments in your foot are severely damaged or shifted from their usual position (displaced) by your injury. This is especially important after severe traumas or accidents. A surgeon will make sure your foot is repaired back to its original shape by putting plates and screws into your foot while your bones and connective tissues heal. Lisfranc surgery is outpatient surgery, meaning you will likely go home the same day. Expect to spend up to three months in a combination of a cast and boot after your surgery.
Treating a Lisfranc injury or fracture can have several risks:
Mild symptoms can be treated at home:
Your provider or surgeon will give you specific instructions for how to care for your injury during/after treatment or surgery. If your symptoms don’t get better after a few days of these at-home treatments, you should get your foot examined by a healthcare provider.
Talk to your provider before taking any medications to reduce pain after any treatment. Over-the-counter pain relievers (such as ibuprofen or acetaminophen) may reduce pain and swelling.
Remember: Everyone’s body heals at different speeds, so make sure to talk through your exact treatment timeline with your provider.
Lisfranc injuries happen from accidents and without warning. Because falls and slips are common causes of Lisfranc injuries and fractures, make sure your home and workspace are free from clutter that could trip you or others. If you play sports, make sure you’re wearing appropriate footwear that gives you the best support and protection.
Healing time depends on the severity of your fracture and which treatments you needed. It can take anywhere from a few months to more than a year to recover fully.
Your ability to work or go to school may be limited, depending on your job or where you go to school. Because you’ll be unable to walk long distances — or put any weight on your injured foot — you might need to miss work. Your provider or surgeon will tell you how long you should wait before returning to walking, exercising or playing sports. In many cases (especially if you have a Lisfranc fracture) it might take a year or more before you’re cleared to return to heavy exercise or sports.
If you think you have a Lisfranc injury or fracture, get it examined by a healthcare provider right away. This includes having any of these symptoms:
If your symptoms don’t get better after a few days of at-home treatments like icing the area and keeping it elevated, you should get your foot examined by a healthcare provider.
If you experienced a fall or other trauma, make sure you tell your healthcare provider or the emergency responders everything that happened.
Lisfranc injuries are extremely unlikely to heal on their own. Because they’re so tricky to diagnose, what might seem like a simple sprain or another common injury could be something much more serious. A neglected Lisfranc injury can become much worse if it’s not examined by a qualified healthcare provider as soon as possible.
A note from Cleveland Clinic
You might have injured your Lisfranc joint missing a step on the basement stairs or as part of a larger, scarier trauma like a car accident. No matter what caused it, any unusual pain, swelling or bruising in your foot should be examined by a healthcare provider as soon as possible. Even if your injury ends up being something less serious, a Lisfranc injury — especially a fracture — can lead to lots of issues later on if you don’t get it treated correctly right away.
Last reviewed by a Cleveland Clinic medical professional on 12/27/2021.
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