About Lisfranc Fractures

Thought I'd offer a little info about the type of injury I have. When I initially went in to the doctor, they said it seemed like I had a broken metatarsal, but they couldn't tell for sure and nothing was displaced. They casted me and sent me on my way. The next week I went to a podiatrist, who said it was definitely broken, but that it didn't make sense to do another set of x-rays until the swelling had gone down. She sent me to a podiatric surgeon thinking it might be a lisfranc fracture, but that it wouldn't require surgery because of no displacement. So the next week I went to the surgeon and she did more xrays. When the swelling went down, all the bones went with it. Apparently that's all that was holding my foot together. She made it very clear that I would need pretty immediate surgery and I cancelled my trip to Panama. :(

So about the injury. It's called a lisfranc fracture, named after an 18th century surgeon. It happens when the ligament between a metatarsal (long skinny bone) and a tarsal (short bones in front of the ankle bones) ruptures. Sometimes you can heal it with just a cast if the bones don't move, but when they move out of place you have to have surgery to reset them.

Click here for a great diagram of the injury pre and post surgery.

Frequently, the ligament between the first tarsal and the second metatarsal ruptures, which leads to the metatarsals all moving toward the outside of the foot. Wikipedia has pretty good info on this stuff, but also has a decent xray pic (right).

Now MY injury was slightly different. The 2nd-4th metatarsals were all moved to the left as in the example xray, but there was also a big space between the first two tarsals (the bigger bones at the bottom). My 1st metatarsal had moved in so much that the 1st tarsal protruded and made a big bump on the right (into my arch). It also went up so when you looked at it from the side it was a like a big step where it's supposed to be flat. Mine looked a little more like this:

 

I'll post mine when I get them on disc.

The injury happens when the toe and metatarsal part of your fit go one direction and the ankle and tarsal part go another. For example, Wikipedia has a great little description of common injuries:

This type of injury classically occurred when a horseman fell while riding, having trapped his foot in the stirrup or fallen into a drain. At present, such an injury happens typically in activities such as windsurfing (where participants' feet are in foot straps that pass over the metatarsals), or when one steps into a hole and the foot twists heavily.

At least I've learned a bit during this process. Will share more when I get more.