Lisfranc Injury

A Lisfranc injury is any damage to the Lisfranc joint on top of your foot. It’s where your metatarsal bones (the bridges to your toes) connect to the rest of your foot.

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.

Visit a healthcare provider if it’s hard to move or use your foot — especially if you slipped, fell or know you hurt your foot recently.

Types of Lisfranc injuries

Lisfranc injuries can affect the bones or ligaments in your joint. Depending on which part of your joint is damaged (and what causes the injury), you might experience a:

• Lisfranc dislocation
• Lisfranc fracture (a type of broken foot)
• Lisfranc sprain (ligament tear)

Symptoms of Lisfranc injuries

Lisfranc injuries cause symptoms near the top of your foot, including:

• Bruising (you might notice a bruise on the bottom of your foot)
• Foot pain (pain might get worse when you try to stand, walk or move)
• Swelling
• Trouble putting weight on your foot

Lisfranc injury causes

Lisfranc injuries are almost always the result of falls, slips or 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. Athletes can injure their Lisfranc joints playing sports, but even a small stumble, or missing a stair or step, can cause an injury.

Traumas that crush the Lisfranc joint can also cause Lisfranc injuries. Examples include:

• Car accidents
• Falling off a ladder
• Something falling on your foot
• Slipping off a curb while walking

Risk factors

Anyone can experience a Lisfranc injury, but you might be more likely to if you:

• Have a condition that damages or makes it harder to feel your feet (especially diabetes-related foot conditions and diabetes-related neuropathy)
• Have a physically demanding job, work with tools or lift heavy objects often
• Play competitive or contact sports

Lisfranc injury complications

If it’s not treated properly, a Lisfranc injury can lead to serious complications, including:

• Arthritis
• Chronic pain
• Collapsed arches and other foot deformities

How doctors diagnose Lisfranc injuries

A healthcare provider will diagnose a Lisfranc injury with a physical exam and some imaging tests.

They’ll examine your foot and the area around it to check its shape and stability. Tell your provider what you were doing when you injured your foot or before you noticed symptoms.

After a physical exam, you’ll probably need at least one of a few imaging tests to take pictures of your foot, including:

• Foot X-ray
• MRI
• CT scan

How do you treat a Lisfranc injury?

The most common Lisfranc injury treatments include:

• Ice and elevation. Try to keep your foot above the level of your heart as often as possible. You can prop it up on pillows or cushions. Wrap ice packs in a thin towel to avoid putting them directly on your skin. You should ice your foot for around 20 minutes at a time, a few times a day.
• Immobilization. Your provider will probably put your foot in a boot or cast. This will reduce stress on your foot, hold it in place and keep you from putting too much weight on it. You might need to use crutches.
• Lisfranc surgery. You’ll need surgery if the injury makes your joint unstable. A surgeon will repair your Lisfranc joint and put plates and screws into your foot to hold the joint in place. After surgery, you’ll need to be off your foot for a month or two. You’ll wear a boot or cast for a few months. Your surgeon might remove the plates and screws after your joint heals.
• Pain medication. Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) or acetaminophen can relieve pain and reduce swelling. Talk to your provider before taking these medications for more than 10 days in a row. Your provider or surgeon might give you prescription medications. They’ll tell you how often it’s safe to take them.

When should I see my healthcare provider?

Visit a healthcare provider if you’re experiencing Lisfranc injury symptoms that don’t get better after a few days of rest and icing your foot. See a provider if you can’t put weight on your foot or walk normally.

Tell your provider if symptoms come back or get worse after you’ve started immobilization or had surgery.

Lisfranc injury recovery time

How long it takes a Lisfranc injury to heal depends on which type you have and what caused it.

Remember: Everyone’s body heals at different speeds, so make sure to talk through your exact treatment timeline with your provider.

• Nonsurgical treatments. You’ll probably need immobilization for six to eight weeks, followed by some physical therapy (PT). A physical therapist will help you regain your strength, balance and mobility.
• Lisfranc surgery. You’ll need up to three months in a boot or cast after your surgery. Your surgeon will tell you when it’s safe to start PT.

Can you still walk with a Lisfranc injury?

You might be able to walk with a Lisfranc injury. But you shouldn’t force yourself to use your foot if you’re in pain or have other symptoms. Continuing to use your foot can make a minor injury more severe and increase the chances that you need surgery.

It’ll probably be OK to walk in a boot or cast, but you should avoid running, jumping or any intense physical activities. Ask your provider which activities you should avoid while you recover.