Nonsurgical Treatment
Anyone who has symptoms of a Lisfranc injury should see a foot and ankle surgeon right away. If unable to do so immediately, it is important to stay off the injured foot, keep it elevated (at or slightly above hip level) and apply a bag of ice wrapped in a thin towel to the area every 20 minutes of each waking hour. These steps will help keep the swelling and pain under control. Treatment by the foot and ankle surgeon may include one or more of the following, depending on the type and severity of the Lisfranc injury:
- Immobilization - Sometimes the foot is placed in a cast to keep it immobile, and crutches are used to avoid putting weight on the injured foot.
- Oral medications - Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, help reduce pain and inflammation.
- Ice and elevation - Swelling is reduced by icing the affected area and keeping the foot elevated, as described above.
- Physical therapy - After the swelling and pain have subsided, physical therapy may be prescribed.
When Is Surgery Needed?
Certain types of Lisfranc injuries require surgery. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient. Some injuries of this type may require emergency surgery.
Complications of Lisfranc Injuries
Complications can and often arise following Lisfranc injuries. A possible early complication following the injury is compartment syndrome, in which pressure builds up within the tissues of the foot, requiring immediate surgery to prevent tissue damage. A buildup of pressure could damage the nerves, blood vessels and muscles in the foot. Arthritis and problems with foot alignment are very likely to develop. In most cases, arthritis develops several months after a Lisfranc injury, requiring additional treatment.