Lisfranc Injuries
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Overview
Foot fractures are common injuries but some can be serious and require surgery. Most fractures will simply be a crack in the bones and will go onto heal with CAM boots or bracing. Some fractures don’t heal and others involve the ligaments which help to keep the alignment and arch of the foot in place. Lisfranc injuries of the foot occur after twisting type trauma or falls. They often involve fractures and injured ligaments such that the foot becomes unstable and prone to severe arthritis.
Assessment
Dr Stevens will assess your injury and organise x-rays and scans if required. If surgery is needed, Dr Stevens will help guide you through the process as a successful outcome will require recovery and rehabilitation sometimes with physiotherapists close to your home location in Melbourne.
Treatment
Non-operative management
A simple crack in the bone, while painful, will normally heal well. Dr Stevens will immobilise the leg and advise treatment with a cast. Follow up x-rays will be required.
Surgical management
If the broken bone has moved too much or if there is instability of the ankle, surgery to lock the bone back in place maybe the best option. This is normally done within few days of the injury. A plaster maybe required to stabilise the fracture prior to surgery. If the ankle is too swollen, elevation and bed rest may be required – sometimes for up to one week.
Risks associated with surgery
As with all surgery, there are risks with fixing your foot fractures. These include infection, delayed healing or wound problems. Difficulty with pain and range of movement may also be occur. Often, further surgery or surgery to removal the plate and screws is required.
Post-operative management
Once fixed, you may be able to begin to move the hip and knee under the instruction of Dr Stevens. Placing weight on the leg will depend on the exact type of fracture you have and how it needed to be fixed.
A plaster and crepe will be placed over the leg following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed.
Elevate the leg for the first few days following surgery. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home
After your surgery you will stay in hospital overnight and potentially for a few days. You will be discharged with pain relief tablets.
Pain relief
After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the plaster
You will need to keep the plaster bandage clean and dry. Using a bag in the shower may help you to do this.
Movement after surgery
You can move your knee and hip straight away after surgery. Your knee will slowly be able to bend in the days that follow your operation. You may experience some ankle and foot pain in the weeks following surgery.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised. When you are resting or sleeping try to keep the leg straight and elevated on some pillows.
Wound review
After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy. A Cam boot may be fitted at this stage. An arch support will be required.
Driving
You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work
This depends on the type of surgery to the ankle you have had and the type of work you do. Most surgeries will need 4-6 weeks off work, some will require longer, especially if you have a manual job.
When to contact us
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Fever
Heavy bleeding or ooze from the wound
Increased swelling and redness around the surgery site
Pain in the calf muscles or difficulty breathing
