The midfoot is an important structure that assists in absorbing forces that come from activities like walking running and jumping. When patients come to Foot Specialists of Long Island seeking treatment for a midfoot injury, they often have one of the common Lisfranc injuries. In severe cases, these injuries can take several months to heal properly, but recognizing the problem and receiving early treatment can keep it from worsening.
Basic Foot Anatomy
Knowing a bit about the basic foot structure can allow you to better understand these injuries and what can be done for them. Our focus is on the Lisfranc joint complex, which is formed by the bones and ligaments that connect the heel area to the forefoot.
The midfoot is responsible for stabilizing the foot arch, and it does this with the use of tarsal bones in the back of your foot. In the forefoot, we find the long, thin bones (metatarsals) that lead to the toes. At the point where the tarsal and metatarsal bones meet, we find the Lisfranc ligament that connects them. This tough band of connective tissue provides strength for the joint and keeps the bones properly aligned.
Lisfranc Injury Symptoms and Causes
The most obvious signs of an injury in this area are bruising (found either in the top or bottom of the foot), swelling in the top of the foot, and pain that progressively worsens with physical activity or even while standing.
Injuries are sustained from either direct or indirect forces on the foot. Many times, an injury occurs in response to excessive twisting (especially in sports like soccer or football) or from a fall of some distance. In athletic participation, a midfoot injury will often happen when an athlete has his or her foot planted in a downwards, flexed position and then stumbles over the top of it. In the case of direct trauma, there can be multiple fractures and dislocations in the joint complex.
Types of Lisfranc Injuries
Three different injuries might be sustained in this area, either independently or in combination with each other. These are:
- Fractures – There are various ways bones in the complex can become fractured, including avulsion fractures (where a tiny piece is pulled away from the main bone) or outright breaks.
- Dislocations – In some cases, bones are forced out of their intended positions by excessive physical force.
- Sprains – When ligaments in the joint complex become strained, it can lead to instability within the joint.
Treating Midfoot Injuries with Conservative Methods
First aid steps for treating an injury involving these bones and ligaments includes the use of ice, elevation, and rest to both protect the area from further damage and to reduce pain and swelling. Further options that we may prescribe, depending on the nature of the injury, include oral medication, immobilization, and physical therapy. Immobilization may entail a cast or crutches to keep bodyweight off the area.
Lisfranc Surgery and Recovery
Surgery may be a recommended part of treatment, depending on the severity and nature of the injury. Surgical procedures that might be used include fixation and fusion. When internal fixation is performed, bones are lined up in their proper places and then secured with the use of screws and/or plates. After about 3 to 5 months, the screws and/or plates will be removed to allow for increased movement.
Fusion is an option that is more commonly used for severe cases that are damaged beyond other means of repair. This procedure will fuse damage bones together, and the will heal into a single, solid piece. In the event that screws or plates are used for fusion, they will likely not be removed.
Effective Treatment for a Midfoot Injury in Long Island
Whether we use conservative or surgical methods for your Lisfranc injury at Foot Specialists of Long Island, you can be assured that our goal is to provide optimal pain relief and restored functionality of your foot. Contact our Nassau County, NY podiatrist office today by calling (516) 804-9038 or schedule an appointment online.