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LIS FRANC Fracture and dislocation

Discussion in 'Ask your questions here' started by RabidGinFairy, Jul 14, 2010.

  1. RabidGinFairy

    RabidGinFairy New Member


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    On 20th June 2010 I sustained a lisfranc injury. I'm 27 now:

    Homolateral Lisfranc fracture of the right foot and comminuted intra-articular fracture longitudinally thru the base of the 1st metatarsal, involving and passing through the plantar aspect of the first metatarsal. No associated of any significant dislocation, and several bony fragments are seen at the plantar surface of the distal aspect of the fracture.
    Fracture base of 2nd metatarsal, also intra-articular in nature. Associated with displacement laterally, with multiple small bony fragments within the joint spaces.
    No definate facture of the first 2 cuneiforms, however there appears to be a partially impacted facture of the third cuneiform involving its metatarsal articular surface
    Fracture longitudinally involving the medial 3rd metatarsal.
    Fracture longitudinally involving the medial 3rd metatarsal
    Fracture through the lateral aspect of the 4th metatarsal. these are also displaced laterally.
    No definate facture within the 5th metatarsal
    Ankle joint fine.

    Proceeded to OT of R foot ORIF on 28/06/10. Fusion 2nd + 3rd TMT joints, bridging plating 3rd + 4th TMT joints.

    I have 3 plates and a staple, the 2 outermost plates are to be removed after 3 months from first surgery.
    They've said I'm to be 3 months non weight bearing, almost 7 weeks in a cast and a moon CAM boot after this.

    It was diagnosed straight away and I had surgery a week after the injury. I know this is an impossible question, but I'm wondering at my chances of recovery, I'm not an athlete but obviously being able to run for a bus would be nice. Its all total doom and gloom on these forums with such a nasty injury but I realise a lot of people that post on here will be having difficulties.
    I've had it elevated as much as possible and haven't had much pain at all. I'm only taking medication to reduce swelling but have heard this can be detrimental to bone healing?
    I was due to have the cast removed on the 5th August but this has been delayed to the 12th (as the clinic is having changes made). I wondered if I could remove the cast on the 5th and perhaps strap the foot, just to give me a week of half sanity back!!
    It seems a lot of lisfranc people have started to apply a little bit of weight after the cast was removed?

    Thanks all, feedback from anyone is much appreciated :)
     
  2. FootDoc

    FootDoc New Member

    You have sustained a serious injury for which you should be relying on hands-on medical advice from doctors intimately familiar with your specific injury and treatment, not the anecdotal comments or suggestions of those who have had a one-time experience with a problem which likely is not sufficiently analogous to yours for either they or you to draw relevant conclusions. I would find it difficult to believe that a responsible doctor, having only the facts at hand, would chime in with a meaningful comment. Prognosis and expectations for the degree of recovery is something which only your attending doctors could responsibly estimate, and even they may be far off the mark.

    Of COURSE you will hear mainly gloom and doom on forums such as this. Those without problems do not peruse such venues.
     
  3. RabidGinFairy

    RabidGinFairy New Member

    Thankyou for that, its easy to get discouraged with so many people struggling with this injury.
    I'm currently taking Omega3 and Glucosamine as well as a general bone health supplement with Magnesium and Calcium. Is there any other supplement or herb that has been proven to help in bone healing?
    I am taking some pain medication for anti inflamm purposes but have heard that anti inflams can hinder bone healing, is this true?
    Many Thanks
     

    Attached Files:

  4. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***************************************************
    There have been some animal studies which seem to indicate that NSAIDS might adversely affect bone healing. How scientifically theoretical as opposed the clinic this might be I do not know. Bone health requires good nutrition, but I don't know that taking supplements rather than eating a good diet is an adequate way of obtaining them, and extra is not necessarily better.
     
  5. RabidGinFairy

    RabidGinFairy New Member

    Thankyou, I wondered if it is normal/common to still have some moderate swelling noted at the top of the foot and toes one month after surgery. Colour is fairly normal. I am still in a fibreglass cast which is roomy enough, this is due to come off 12th Aug, 6.5 weeks after surgery. It seems most lis franc fractures are able to partial weight bear after the cast is removed, using a moon (CAM?)boot. If the foot feels good, will I be able to work on ambulation or is it best to stay off completely until after 6 weeks with the CAM boot? Many Thanks for your opinion..
     
  6. FootDoc

    FootDoc New Member

    It would not be uncommon to still have some swelling a month after surgery. Instructions as to when to begin or increase ambulation should be gotten only from the attending doctor.
     
  7. RabidGinFairy

    RabidGinFairy New Member

    Hi Foot Doc, as to the above injury, just over 3 weeks ago I had surgery to remove some of the metal (11 screws, 2 plates/staples) leaving me with 5 screws, a wire and plate. Progress/pain seems to be getting worse! Is the foot still adjusting to being weakened after having its "scaffolding" removed? Or usually does it simply get better? I am now 5 months post op. Thanks so much for your time..
     
  8. Foot Doc

    Foot Doc Guest

    I have no basis for meaningfully responding to your question. The person to ask about this would be the doctor who is treating you and knows precisely what was done and what should be expected.

    FOOT DOC
     
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