lisfranc injury?

[Ohana]

I went to an orthopedic surgeon the other day and he says I have a lisfranc joint injury! (that's on the top of the foot)

I accidently hit it playing soccer with my dogs over a month ago and finally went to the Dr. cuz it still hurt ;) )

Long story short, he wants me to be in a cast, or a HUGE orthopedic boot for 6-8 weeks.
I have already been walking on it for over a month so I feel kind of silly getting a cast or boot.
He wants me to be "non weight bearing" which means I will be using crutches regardless of boot/cast.

I am not supposed to be using my treadmill, and haven't as it HURTS, like a big pinch every time I step faster than a normal walk speed.

I wanted to know if anyone else has had this injury? What did you do to make it better? How on earth am I going to exercise at all if I have a cast? (at least now I can walk a little)

I am leaning towards a cast if I MUST do something, as I know myself and will take the boot off to walk the dogs, go up the steps, and when seeing my clinic patients etc. I don't think I have the self discipline to keep a boot on all the time, even if a cast does mean I won't be able to shave my leg!

I told the Dr. I would think about it and call him back.. any advice?

[fgummett]

Can't say as I know much about this particular injury but I do appreciate how wonderfully complex the human foot is and how much we come to rely on it every day.

Without meaning to sound patronising... you strike me as the kind of person who might shrug this off and not really take the advice seriously. But consider how much you may be planning to use your foot in the long term and maybe it is worth while putting up with some short term inconvenience :cool:

I would also be considering a second opinion from a physio -- in my experience surgeons are great at surgery (glad to see that is not the first option in this case) while a physio is more inclined to try and help you heal. :) A physio would probably also be the best to advise appropriate exercise...

---

Lisfranc Injury of the Foot: A Commonly Missed Diagnosis - July 1998 - American Academy of Family Physicians (http://www.aafp.org/afp/980700ap/burrough.html)

[Jan B]

My first thought is to do what the doctor suggests. Then I read Franks's response and think it's right on target.

I've never heard of a lisfranc joint. Now I know. Maybe you can still play soccer with your dogs, but go ahead and use one hand . . . and your head!

[foxl]

I would also be considering a second opinion from a physio -- in my experience surgeons are great at surgery (glad to see that is not the first option in this case) while a physio is more inclined to try and help you heal. :) A physio would probably also be the best to advise appropriate exercise...

---

Lisfranc Injury of the Foot: A Commonly Missed Diagnosis - July 1998 - American Academy of Family Physicians (http://www.aafp.org/afp/980700ap/burrough.html)

My boss says of surgeons, "If you have a hammer, everything looks like a nail!"

My daughter has a birth injury and we go back and forth between phys med and surgery MDs annually. So far she is 8 and AVOIDED SURGERY. Which is wonderful! She really is fully functional, without it!

Surgery is always a tradeoff ... something will be compromised, not work as well. Scar tissue forms. IF you can avoid it through other, equally effective therapy, DO!

[A_Darling]

Those foot bones are very sensitive when injured, that doesn't sound like a fun one. I would suggest doing everything by the book and allow the bone to heal as much as possible.

The tarsals and metatarsals in the foot do not have great blood flow so you need to be very careful when they are injured. Damage the blood flow too much and you could have a dead bone in your foot (i've heard horror stories about this type of thing in people's wrists, same issue with bone blood flow). Sorry if this is frightening, but it's better than being naive.

Good luck!

[Ohana]

thanks for the responses.

The Dr. has not yet even mentioned surgery. I thought he would send me to therapy so when he mentioned a cast I was shocked (since I can walk on it an everything)

I think I am going to go see a physio. It can't hurt, and fgummett is right, I am more likely to blow off restrictive activity now, at the cost of better long term results (even though I know I shouldn't :o )

This is why I brought up the cast/boot issue. If I do decide to do this, I think I will go with an old fashioned non weight bearing cast so I HAVE to do it. Even though I hate to admit it, self discipline has never really been my strong suit... (I am slowly working on that!)

[SCC]

Years ago, I broke my little toe. Initially it was taped up at the ER clinic. A day or two later I went to a sports medicine doc, they showed it that it was broken in 3 places and I had a choice. One - just keep it taped and it would "probably heal OK", or two - rebreak it, set it and put the little toe, adjoining toes in a cast up to my knee.

I said, I'm a diabetic, I like to run, so bring on the cast.

Everything healed up fine, and I have no trouble now. It was a pain in the neck but I think it was the right decision.

I didn't do much cardio, but did a lot more strength workouts, stretched. Just getting around in the cast was more workout than I thought! My cardio fitness recovered really quickly when I was "back".

And probably good to work with a physical therapist coming back so you can strengthen and not overdo :)