Lisfranc injuries refer to injuries to the bones or ligaments that support the mid-foot. Severity of the damage caused can vary from mild to complex and can also involve more than one joints and bones of the mid-foot.
Lisfranc injuries are often mistaken for foot sprains, especially if injury occurs due to obvious damage caused by twisting the foot or falling from a height. It is important to note that a Lisfranc injury is not as simple as a sprain and it cannot be ‘walked off’ to reduce symptoms. A Lisfranc injury may take several months to heal and can even require surgery to repair the damage.
Important: The information posted on this page on Lisfranc injuries and sprains and strains is for learning purposes only. To learn to recognize and manage Lisfranc injuries, sprains, strains and other foot injuries enrol in workplace approved first aid classes here.
Lisfranc injuries can occur from twisting the foot and falling from heights. This injury is common in soccer and football players and often occurs when a person stumbles over, causing the foot to flex in a downward motion.
Severe types of this injury occur from direct trauma to the foot – for example, from falling from a height. These are high-energy damages that can result in multiple injuries, fractures and dislocations.
Signs and symptoms
Signs and symptoms of Lisfranc injuries include:
- The top part of the foot may be painful and swollen
- Bruising on the top or bottom of the foot
- Worsening pain while standing or walking – the casualty may require crutches to walk
If standard treatment of relieving symptoms such as pain and swelling do not work, seek medical attention from an orthopaedic surgeon.
Tests and diagnosis
Physical findings of Lisfranc injury include:
- Bruising along the bottom of the injured foot – this signifies a complete tear in the ligaments of the mid-foot or a fracture to the mid-foot
- Tenderness upon applying pressure, also called palpation, along the mid-foot
- Pain with stress. The doctor may grasp the heel of the affected foot and twist the front to determine if there is any pain. An uninjured foot will not hurt
- A piano key test. The doctor will move the toes of the injured foot up and down to check whether it causes pain
- Single limb heel rise. You may be asked to stand on one foot and try to rice on your toes. This will put stress on your mid-foot, if there is pain, you have a Lisfranc injury
Most of the time treatment for a Lisfranc injury is done through surgery; however, minor injuries may be treated with first aid methods. Initially you may have to perform the RICE method: rest, ice, compress and elevate, to see if symptoms subside. If symptoms are persistent, you may have to seek medical attention and get surgical repair done.
For minimal displacement of the mid-foot structures, a stiff walking sling or cast may be applied for around 8 weeks. However, your doctor will most likely align the structures with screws or plates to support the mid-foot, which will be removed once treatment is complete.