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Lisfranc surgery recovery question

Discussion in 'Ask your questions here' started by Cassidy, Dec 23, 2016.

  1. Cassidy

    Cassidy Member

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    I will start by giving a rundown of my injury and timeline of events since injury, I would love to hear if anyone has any similar experiences and if things progressed with or without the need of a fusion in the future.

    I sustained my injury May, 14th after slipping on a Tupperware bowl in the kitchen. I went to the ER where I was told it was a minor sprain and I should be fine in a week. 2 weeks later my foot was still swollen and looked slightly deformed so I went to my family doctor who DX me with tarsal tunnel, told me to elevate and heat and said it should be better in 2 weeks. 4 weeks later I saw a podiatrist since it still was not improving, had weight bearing x-rays done in the office and was notified that I had a lisfranc injury and sent me to a foot and ankle surgeon.

    The foot and ankle surgeon informed me after an MRI that I had ruptured the ligament between the first and second metatarsals, he stated that the first metatarsal was shifted to the outside of the foot and the second metatarsal was shift to the inside of my foot, it was an injury that only involved the ligament. I was given the option of open reduction or fusion and we decided on open reduction, he utilized plates to minimize any trauma to the joints and said we could go back for fusion if need be in the future.

    I had surgery on 7/13 had 2 plates and 8 screws placed. Healing seemed to progress as expected i had the hardware removed on 11/10. I saw my doc on 11/23 he said all looked good and i was allowed to go to a shoe with an orthotic, he said I could try walking on my own without physical therapy and to call him if I felt I needed it. Well needless to say the pain in my mid foot was extreme when trying to walk normally. This did not improve over the course of 2 weeks so I started physical therapy on 12/9. My question is, the pain I'm having is the same as before surgery and so far has not improved, pain is minimal when not weight bearing but extremely painful when bending the midfoot. When I am a walking boot I experience minimal pain, have others experienced the same thing and still improved with time? Also I cannot walk without a severe limp right now and wondering how long it took others before they felt their walking improved? My Physical therapist is concerned that I still have instibility in the joint, I see my surgeon on 1/10 and he wants to dicuss possible fusion. I am hoping that what I am experiencing is common and might improve with time or if it would be best to do the fusion sooner than later. I have a 2 and 3 year old and I am so ready to be able to do more with my kids.

    So for such a long post, hope to hear insite on others experiences.
  2. Cassidy

    Cassidy Member

    Since I posted this, my physical therapist tried having me go back in a boot for 3 weeks, I thought my foot was getting slightly better but after 1 day out of the boot it's right back to where it was. I am having a lot of popping in the joint where the ligament was ruptured, this is to the point I can push up slightly on that bone and make it pop at the joint. Has anyone experienced this after lisfranc ORIF? If so is it to be expected? I see my surgeon on tuesday, my Physical Therapist feels something isn't right in that foot and I'm just hoping he's wrong and all of this is to be expected. Any experience would be appreciated, I am 6 months post first surgery and 2 months post hardware removal.
  3. Cassidy

    Cassidy Member

    I am going to update this post so in the event someone else is in a similar situation to me in the future they can read this and maybe get some insite...

    I saw my surgeon on 1/10 as soon as I started describing the popping and pain I was feeling he said he had a strong suspicion that the Open reduction procedure had failed. Upon exam he could manually move the bones in the lisfranc joint with tenderness. He felt strongly that the next step would be a fusion of my 1st and 2nd metatarsals. I am currently awaiting my surgery date.

    My advice to anyone going through this type of injury would be to research the two surgery options in depth, most people who have ORIF end up going on to have a fusion later, many argue that going straight to fusion may be the better option.
  4. FITz

    FITz Guest

    hey cass do u have an email. I need a friend. Ur the most recent post i have found for this injury. No surgery yet. Injury occured 8/2/16. Suffereing every step since. Help.
  5. Cassidy

    Cassidy Member

    I do have an email address but I am more active on a Facebook page called "lisfranc injury & life afterwards. It is a fantastic board full of helpful people. This will not let me post my email. I am a member of the Facebook board and would be happy message you there as well :). I am currently 13 weeks post op from fusion and have lived with pain everyday for a year from this awful injury, I am still struggling to walk and may have to go in for a 4th surgery to remove hardware, I will find out for sure in 5 weeks. What did you do and what is the nature of your injury? ( Ligament only, FX only, both, how many bones/joints involved) I am more than willing to be of any help I can he for you, I have done more research the I would like to admit on this injury.
  6. S. White

    S. White Guest

  7. S. White

    S. White Guest

    I fractured/dislocated my 1st tarsal metatarsal joint July 22, 2016 as a result of a fall from a ladder. At that time I had an open reduction internal fixation (ORIF). After 12 weeks non weight bearing my x-rays continued to look good. I was allowed to bear weight and continued to wear a boot for several more weeks. A few months later the plate and 6 screws were causing problems and an x-ray showed that I needed a fusion. December 23, 2017 I had a fusion with more plates and screws. 12 more weeks non weight bearing and my x-rays again looked fine. March 23 I went back to work with my boot and within 7 weeks was having problems with my hardware again. June 1, 2017 I had a revision of my midfoot fusion. I now have at least 12 more weeks non weight bearing and was informed by my surgeon that he put new screws and one very large and lengthy screw with a plate and bone graft. I hope losing the excess weight will help and that this time will be a success. My bone quality is poor so that is another strike against me. These types of injuries are so unpredictable. I didn't have a choice for an ORIF or a fusion the first surgery but if I had I would have went for a fusion and not had the ORIF. A great number of the ORIF eventually have to be fused so why bother just go straight to the fusion. I have an excellent surgeon but a uncooperative foot and there is only so much that can be done. I wish everyone the best with your recovery!!
  8. Cassidy

    Cassidy Member

    I am now 18 weeks post fusion, I am having pain with every step I take, my Surgeon has assured me that my fusion has fused really well, but I'm still having pain. I am now having pain in the 3rd Metatarsal that I will he having a cortisone shot in, hopefully it will help the pain, for now at least. I've been told that my pain is most likely from the hardware and will probably have it out the end of the year. I would like to know how you knew there were issues with the hardware? I have been at this for 13 months now and feeling defeated, this injury is definitely unpredictable.
  9. Cassidy

    Cassidy Member

    I just thought I would update this post with my unique experience...

    I am currently 6 months post op from fusion of the 1st and 2nd metatarsals, after ORIF failed for a lisfranc injury. I have continued to have pain during the push off phase of walking, I tried custom orthotics, cortisone injection and PT, non of which helped at all. I noticed after fusion that my foot was pronating severely upon standing and I have a complete loss of arch. I saw my doctor and he thought I needed to have Hardware removal to see if that helps. After talking to him further about the pronation I am having he thought maybe I had a secondary Injury that was missed. I had an MRI done to evaluate the hind foot and ankle. The tests came back stating that I have an accessory navicular bone which he said likely caused my Posterior tibial tendon to stretch a bit easier when I fell originally.

    He believes most of my pain is caused by the pronation and flat foot and some is caused by hardware. So I am now awaiting a Surgery date for flatfoot reconstruction and hardware removal, hoping that this will help my pain significantly. After 1 1/2 years of pain and a severe limp, I am hoping this will at least get me on the road to be able to walk somewhat normal.

    I hope anyone who has this injury heals great, but if you do have issues don't be afraid to ask questions, sometimes things don't go quite as expected.
  10. BigJeefJerky

    BigJeefJerky Guest


  11. Cassidy

    Cassidy Member

    I am updating this thread just in case someone in the future might find this helpful.

    So if you read from the beginning I have had many problems since sustaining a lisfranc Injury. I decided to get a 2nd opinion after my doctor diagnosed me with a severe flat foot.

    I saw the 2nd opinion doctor, who did a CT scan and many x-rays, along with an extensive physical exam. He said I did have a severe flat foot that needed to be corrected, but that I also had a 3rd metatarsal dislocation that was missed from the original Injury. He notified me that I would need the following:

    Gastrocnemius Recession
    Accessory navicular bone removal
    FDL tendon transfer
    Calcaneal Osteotomy
    3rd TMT joint fusion
    Removal of 1st Metatarsal hardware.
    Cotton Osteotomy
    Evans Osteotomy

    Surgery would take 5-7 hrs depending on what he found once in there and would be in patient.

    I had surgery on 10/10/2017, he ended up not needing to do the Evans Osteotomy or the cotton Osteotomy, because he found he could repair my spring ligament and my foot was in good alignment afterwards. Surgery was about 6 hrs and I spent 2 nights in the hospital due to lack of pain control.

    I am hopeful that this will at least improve my situation and allow me to eventually walk without a limp most of the time.

    Anyone struggling with recovery, definitely don't hesitate to get a 2nd opinion, sometimes it is helpful to have a new perspective.

    Good luck to anyone going through any lisfranc Injury.


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