A Lisfranc injury involves a combination of fractures and dislocations of the bones and joints in the midfoot. When one of the bones in the midfoot is broken, or one of the ligaments torn, the arch will collapse, guaranteeing arthritis in the midfoot. The collapsed arthritic midfoot is one of the most challenging reconstructions in Ankle and Foot surgery. Satisfaction rates after surgery are low despite the pain control obtained as it just never feels right and the push-off power is difficult to generate. Therefore, midfoot fracture dislocations are almost always treated surgically.
The surgical center will inform you when to arrive and how to prepare for surgery. General anesthesia is routine.
You will be given antibiotics just before surgery to help prevent infection. During the surgery a tourniquet will be placed around your calf. The fracture and dislocations are reduced and stabilized. A primary fusion is performed if the joint is damaged beyond repair. X-Rays are taken to confirm bone position. The wounds are closed with stitches. A sterile dressing and cast are applied.
Immediate Post-Operative Care
Once your anesthesiologist is satisfied that you have recovered you will be permitted to leave the surgical center. During this recovery time your family member may take your prescription to the nearest pharmacy. You will be given crutches and a walking boot. Take your narcotic pain control medication before falling asleep or as you feel the “numbing” effect wear off. Remember post operative pain is much easier to control with prevention. Call to schedule your post-operative visit for 2 weeks after surgery when you feel able.
To schedule surgery, please contact usi at firstname.lastname@example.org or 952-920-4333 ext 5. Please be patient as we work to find a time in my schedule. We knows your surgery must be done urgently and we will be looking to place you at our surgical center. If you have questions after surgery, please contact my office.
|Elevation||23 hours / day for 3 days; then keep elevated as needed. Swelling may last over 4 months.|
|Motion||Move your toes and knee when the block resolves. This will decrease pain, swelling, and improve healing.|
|Walking||If you are healing well I will permit you to begin heel weight bearing at 6 weeks in a fracture brace.|
|Bathing||Keep cast dry. Use a DryPro waterproof cast bag. There are no restrictions after the cast is removed.|
|Dressing||Apply a Bioskin Aftercare Brace for swelling control. Use silicone sheets to diminish the scar thickness.|
|Pain Control||Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Ultram (Rx only). NSAIDS will slow healing.|
|Work||Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor and sports will take at least 3 months.|
|Driving||Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until healing is adequate and they feel safe.|
Routine Clinic Visits
|2 weeks||X-ray, cast and staple removal.|
|6 weeks||X-ray, the earliest time of bone healing to permit weight bearing activity. The time to return for your next visit varies significantly.|
|14 weeks||X-ray, plan removal of hardware.|
|4-6 months||Return for recheck. Strength improves over then next year. Minimal feelings of discomfort may linger, your overall comfort level improves over a year.|
|**********||If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office.|
Before surgery, consider ordering a Full-leg DryPro, a waterproof cast sock from www.anklefootmd.com and select the on line store from Additional Resources.
Visit our video center to watch rehab exercise videos that will help you recover after your surgery.