Lisfranc Injuries- A Common Misdiagnosis

Some say that Lisfranc injuries are rare, but that may be due to the fact that up to 20% of Lisfranc injuries are misdiagnosed as a sprain by physicians. The reason for this may be the methods for determining the type of injury the patient has based on first evaluation. The different types of tests a physician can use, usually all result in some level of discomfort in the foot region which can lead to a misdiagnosis.  That is why further investigation is necessary in the form of medical imaging.  Medical imaging will allow the physician to look for fractures in the metatarsal bones, widening between joints or dislocation of the joints in the mid foot[1].

What exactly is a Lisfranc injury?

Second metatarsal fracture w/ dislocation of third through fifth tarsometatarsal joints.

Lisfranc (midfoot) injury is when the bones of the midfoot become broken or dislocated, or the ligaments that support the midfoot have been torn.

This type of injury can occur from a simple twist and fall, to direct impacts by falling from high elevations or car accidents.

Symptoms of a Lisfranc injury include:

  • Swelling & pain of the midfoot
  • Decreased or inability to bear weight on the foot
  • Bruising on the top of the foot and especially the bottom of foot
  • Pain that worsens with standing, walking or bearing weight on the foot

A proper diagnosis of a Lisfranc injury is crucial.  “When one misdiagnoses Lisfranc injury as a sprain or renders insufficient treatment, complications such as osteoarthritis and midfoot pain result. The outcome of Lisfranc injuries depends on the severity of injury to the cartilaginous joint surface with the most common outcome being midfoot arthritis.[2]” There is also a chance of one developing a flat foot if proper treatment is not taken.

The treatment of Lisfranc injuries depend upon the severity of the injury.  It can vary from applying a compression bandage and ice, to wearing a short leg splint or boot, a brace with compression wrap, or surgery.

If ice and rest do not provide your foot with relief please make an appointment with your podiatrist for an evaluation, the sooner the better!

 

[1] Weatherford, B. M., MD. (2017, September). Lisfranc (Midfoot) Injury – OrthoInfo – AAOS. Retrieved October 5, 2018, from https://orthoinfo.aaos.org/en/diseases–conditions/lisfranc-midfoot-injury/

[2] Shah, N. N., MD, & DeMeo, J., DPM. (2016). Keys To Diagnosing And Treating Lisfranc Injuries. Podiatry Today,29(4), 60-67. Retrieved October 5, 2018, from https://www.podiatrytoday.com/keys-diagnosing-and-treating-lisfranc-injuries

 

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