The midfoot joint complex is also called the Lisfranc joint. It is named after French surgeon Jacques Lisfranc de St. Martin, who served as a surgeon in the Napoleonic army in the 1800s on the Russian front. He became well known for his proficiency in foot surgery.
Lisfranc’s joint is located at the junction of the forefoot and the midfoot, where a cluster of small bones forms an arch on the top of the foot. Five long bones, metatarsals, extend to the toes from this cluster. The bones are held in place by ligaments. Cartilage covers the ends of bones in the joints, allowing the joints to move smoothly.
Lisfranc injuries result if bones in the midfoot are broken or ligaments that support the midfoot are torn. The severity of the injury can vary from simple to complex, affecting a single joint to multiple joints and fractures. Lisfranc injuries typically damage the cartilage of the midfoot joints.
The most common symptoms of Lisfranc injury include:
- Swelling and pain on top of foot.
- Bruising on both the top and bottom of the foot.
- Worsening pain with standing or walking.
When Lisfranc joint complex injury is suspected, make an appointment with the DOC orthopedic surgeon as soon as possible. After discussing your symptoms, your DOC orthopedist will examine your foot and ankle, including palpation and stress tests of the midfoot. Other tests may be ordered to confirm the diagnosis including X-rays to show any broken bones and the alignment of the Lisfranc joint and an MRI or CT scan to evaluate the extent of the injury and to plan surgery.
Surgery is recommended for all injuries with a fracture in the joints of the midfoot or with abnormal positioning of the joints. Keenan Carriero, DPM, with DOC California explains: “The goal of joint reconstruction for Lisfranc foot fractures is to realign the joints for normal function and to return the broken bone fragments as closely as possible to a normal position. The sooner the surgery occurs after the original injury, the greater the likelihood of success.”
If severe midfoot injuries are not treated, then damage to the cartilage and increased stress at the midfoot joints can result in flatfoot and arthritis, which require complicated surgery to correct.
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