Below is an interesting article on Lisfranc injuries in the NFL.
They appear to be a career limiting injury.
Lisfranc Injuries in the NFL - Link to article
Friday 24 May 2013
Tuesday 14 May 2013
Non-operative Management
Cases treated non-operatively.
These are patients who opted not to proceed with surgery.
As you can see all had x-ray findings consistent with a lisfranc injury. They were allowed to be weight bearing as tolerated in a cast boot and transitioned to a hard sole shoe / hiking boot as pain and swelling decreased. The average time was between 6 to 12 weeks.
Some patients had no pain after the injury had healed, others had minimal pain and decided that surgery + the associated recovery time was not in their best interest.
Case 1:
Case 2:
Case 3:
Case 4:
Case 5:
Case 6:
Case 7:
Case 8:
Case 9:
Case 10:
Case 11:
Case 12:
Case 12 - patient had evident lisfranc injury on right side. Patient was transitioned from a cast boot to a hard soled shoe. At 9 weeks patient no longer had pain and was able to perform a single heel raise. As such we opted not to proceed with a lisfranc fusion procedure.
Case 13:
Case 14:
Case 15:
Case 16:
Case 17:
Case 18:
Case 19:
Foot after closed reduction.
Case 20:
Initial injury x-ray and repeat x-rays 1 month after closed reduction.
7 months post-injury - patient continues to have minimal pain and discomfort - he has returned to work and regular activities.
These are patients who opted not to proceed with surgery.
As you can see all had x-ray findings consistent with a lisfranc injury. They were allowed to be weight bearing as tolerated in a cast boot and transitioned to a hard sole shoe / hiking boot as pain and swelling decreased. The average time was between 6 to 12 weeks.
Some patients had no pain after the injury had healed, others had minimal pain and decided that surgery + the associated recovery time was not in their best interest.
Case 1:
Case 2:
Case 3:
Case 4:
Case 5:
Case 6:
Case 7:
Case 8:
Case 9:
Case 10:
Case 11:
Case 12:
Case 12 - patient had evident lisfranc injury on right side. Patient was transitioned from a cast boot to a hard soled shoe. At 9 weeks patient no longer had pain and was able to perform a single heel raise. As such we opted not to proceed with a lisfranc fusion procedure.
Case 13:
Case 14:
Case 15:
Case 16:
Case 17:
Case 18:
Case 19:
Foot after closed reduction.
Case 20:
Initial injury x-ray and repeat x-rays 1 month after closed reduction.
7 months post-injury - patient continues to have minimal pain and discomfort - he has returned to work and regular activities.
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