Lisfranc (Midfoot) Fracture and Midfoot Arthritis

The tarsometatarsal joint (Lis Franc Joint) is the region found in the middle of the foot. is a junction between the tarsal bones (group of seven “Hind Foot” articulating bones in the foot underneath the ankle) and the metatarsal bones (a group of five long bones in the “fore foot”). A Lisfranc fracture is unstable and needs surgical treatment to try to avoid late onset arthritis of the midfoot.

Tarsometatarsal arthritis is characterized by pain, functional impairment and midfoot instability. In fractures, the appearance of bruising and swelling on the dorsal side of the midfoot are the commonly observed signs. The doctor will first examine the physical condition of the foot by inspection and palpation (feeling with hands). You may be advised to get an X-ray taken. You might also be sent to get a CT or MRI scan done to provide more information about your condition.

Acute Lisfranc injuries are best treated with surgery. The joints need to be openly reduced and internally fixed with screws or plates and screws. Post operatively you are in a brace or a cast and you are non-weight bearing for 3 months. Many people have their internal fixation removed once the fractures have healed.

Patients who were not diagnosed at the time of their injury often go on to develop arthritis. The early stages of arthritis can be treated by analgesics, steroid injections and by wearing special footwear or casts. Tarsometatarsal joint fusion is recommended if all the non-surgical procedures fail to show efficacy in treating the injury.