Lisfranc injuries (mid-foot)
The foot is a complex structure in the human body, made up of 26 bones, over 30 joints and numerous ligaments that ensure joint stability. Anatomically, the foot is generally divided into three main zones: the forefoot, the midfoot and the hindfoot. The Lisfranc joint complex is made up of several midfoot joints, in particular the tarsometatarsal joints. Lisfranc injuries (also known as Lisfranc fractures or Lisfranc dislocations) encompass a variety of conditions affecting this joint complex, including fractures, subluxations, dislocations, sprains, joint widenings or crushes. These injuries are relatively rare, and typical mechanisms include high-energy impacts, such as collisions with external objects (car accidents, objects falling on the foot) or impacts with the ground after a fall. Low-energy injuries are also possible, notably when plantar flexion of the ankle (tiptoe position) is combined with a twisting movement, a frequent mechanism in multidirectional sports such as soccer, basketball, volleyball, etc. As with other fractures, low-energy Lisfranc injuries occur more easily in elderly populations or individuals suffering from conditions that make bones more fragile (e.g. osteoporosis).
Non-surgical management is recommended for minor injuries, usually minor sprains or non-displaced fractures. Treatment, often guided by imaging studies (X-ray or CT scan), includes reduction and immobilization of the injured area. A cast or boot is usually prescribed, accompanied by the use of crutches to take the weight off the joint for 2 to 6 weeks, depending on the severity of the injury. After this period of immobilization, rehabilitation is generally undertaken to facilitate recovery of mobility, improve joint stability, increase muscle strength, optimize quality of movement and, finally, enable a return to performance. At Foxphysio, after an initial consultation with one of our specialist doctors, your recovery plan will take place in four different environments: swimming pool, gym, movement analysis and re-training room, and finally field rehabilitation, to achieve maximum functional recovery and prevent relapses.