Lisfranc fracture is almost always accompanied by dislocation of the Lisfranc joints or the tarsometatarsal joints that are located in the middle of the foot. A twisting fall or a heavy blow can cause this fracture. Connective tissues or ligaments hold the bones in place. The first and second metatarsals are not held by any connective tissue. Hence when a twisting fall occurs, dislocation of these bones takes place. Due to this injury the tarsal bones are dislocated, but (MT) does not occur always. Generally, the fracture and the dislocation are treated independently with stabilization devices. One or more of the tarsometatarsal joints are dislocated when Lisfranc dislocation occurs.
Many times, mistaken for sprains, Lisfranc fractures are associated with swelling of the top of the foot which is also very painful. It is very difficult to put any weight on the foot if the injury is very severe. Often X-rays do not reveal Lisfranc injuries. Serious complications like joint degeneration and compartment syndrome will follow when Lisfranc injuries go unrecognized. If the pain or swelling does not reduce in spite of normal treatment for a sprain, it is better to take the advice of an orthopaedic specialist.
By examining the foot for signs of injury, an orthopedist will move the foot in a circular motion holding the heel steady. A CT scan or MRI scan will show the exact nature of the injury. Open Reduction Internal Fixation (OR IF) is advised for dislocation.
A fracture is called a metatarsal fracture when one of the long thin bones of the foot is fractured. It is also known as broken foot, and can be classified as Jones fracture, stress fracture of the foot, Lisfranc fracture dislocation, marcher's fracture, tennis fracture and dancer's fracture. Human foot has five metatarsal bones. Depending on the extent of injury and displacement, metatarsal fractures can be classified as minor or severe injuries. When this fracture occurs in an area of the foot where there is poor blood flow, the healing is more difficult. Jones Fracture is of this type and requires surgery to position the bones.
Twisting and dropping a heavy object on the foot are the two major causes for most of the metatarsal fractures. Direct impact of the falling object will result in a metatarsal fracture. Since the symptoms of this type of fracture may be similar to an ankle sprain, a metatarsal fracture may be missed at times. Though X-rays will help to confirm the fracture, a
CT scan or MRI is needed only when there are other injuries.
Keeping the injured foot at an elevated position will help to reduce the pain. One can use crutches to avoid pressure on the foot. Stiff soled shoe or a walking cast can be used as part of the treatment. A non-weight bearing cast for several weeks is prescribed for more severe fractures.If a metatarsal fracture has occurred in an area of the foot that has poor blood supply or if the bones are very much out of place, surgery is recommended. Maintaining good balance, good coordination and strength of the foot are some tips one should remember to avoid metatarsal fractures.
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Collection of Pages - Last revised Date: February 17, 2019