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Jade asked thr Guru about a Lisfranc Injury following a car crash

Jul 31st, 2014

I was in a car crash last year and as a result suffered 4 broken metatarsal bones and a lis franc injury on the inside of my left foot.

I’ve been back and forth to the hospital and seen a podiatrist who set about creating some orthotics in order to ‘tease’ the misplaced lis franc fracture back into place. Unfortunately they made the orthotics for the wrong feet (NHS!) and I’m now left with one option which is fusion surgery.

The pain I get, I’m told, is due to injury to my ligaments.

Is there any possibility of looking at physio instead of surgery or would you suggest physio after my surgery to help?

Thanks

Jul 31st, 2014

The Guru Responded:

Hi Jade

Ow!

It sounds as if initially you had an undisplaced or an avulsion fracture – and so the orthotics was to enable your foot to function normally and allow the boney fragment to naturally heal.

If you’ve got ligamentous pain, then it’s most likely you’ve still got an unstable Lisfranc joint. This can be either to poor alignment of the old fracture, non union of the fracture (rare as you’re a year+ down the line) or other bits of your foot and body are moving less due to the excessive motion going through the joint.

Any fusion surgery will totally alter your boney architecture forever. It absolutely has to be the only thing to do WHEN all other non invasive therapies have been exhausted. 

I think it’s well worth seeing a Physio (who knows  what they are doing) to see if they can make sense of your symptoms. And more importantly can they change them by making you move better elsewhere. I’d also think that a decent rehab program to help stabilise your foot and ankle, and your entire lower limb wouldn’t go amiss….

So Physio first – if that fails a decent foot and ankle surgeon last.

Good Luck, 
The Guru

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