Lisfranc Fracture-Dislocation

The most common causes of Lisfranc fracture-dislocation include:

• Direct Trauma: Strong impacts, such as those resulting from car accidents, falls, or sports injuries, can cause fractures and dislocations in the Lisfranc joint.
• Falls: Falls that result in direct impact on the midfoot can lead to this fracture-dislocation.
• Work Accidents: Certain work environments, especially those involving moving heavy objects or direct pressure on the foot, can increase the risk of Lisfranc fracture-dislocations.
• Sports Injuries: Activities involving sudden movements or rapid direction changes, such as football or basketball, can cause fracture-dislocations in this area.

Symptoms of Lisfranc fracture-dislocation may include:

• Intense Pain: Localized pain in the midfoot, which can be sudden and severe, especially when trying to bear weight or move the foot.
• Swelling: Increased volume and fluid accumulation around the Lisfranc joint, often extending to the foot arch.
• Bruising: Formation of purple bruising or dark coloration in the fracture-dislocation area - observe the plantar region of the foot.
• Visible Deformity: In severe cases, there may be a visible deformity or bone misalignment in the midfoot region.
• Movement Difficulty: Significant reduction in ability to move the foot or bear weight due to pain and swelling.

To diagnose a Lisfranc fracture-dislocation, doctors use:

• Physical Examination: Assessment of pain, swelling, deformity, and foot movement capability. The doctor may perform specific tests to evaluate joint stability and identify signs of fracture or dislocation.
• Imaging Tests: X-rays are frequently used to identify fractures and dislocations in the Lisfranc region. In some cases, computed tomography (CT) may be necessary to obtain a more detailed view of bone structure and fragments. Magnetic resonance imaging (MRI) can also be useful to evaluate soft tissue injuries and joint structures.

Treatment of Lisfranc fracture-dislocation can vary depending on injury severity and patient's general conditions:

• Conservative Treatment: In less severe cases or with aligned fractures, treatment may include immobilization with cast or splint, rest, and elevation to reduce swelling (uncommon). Use of analgesics and anti-inflammatory medications can help control pain and inflammation.
• Surgery: In severe cases, such as displaced fractures or dislocations, surgery may be necessary to realign bones and stabilize the joint. Surgery may involve placement of plates and screws to keep bones in correct position during healing.
• Physical Therapy: After cast removal / surgery, physical therapy is essential to strengthen muscles around the foot, improve range of motion, and restore normal function.

Some preventive measures include:

• Use of Protective Equipment: In high-risk activities, such as sports or work, use of appropriate footwear and additional protection can help prevent serious injuries.
• Environmental Care: Maintaining a safe environment and avoiding fall risks or accidents can reduce risk of fracture-dislocations.
• Muscle Strengthening: Exercises to strengthen leg and foot muscles can help improve stability and reduce injury risk.