Who is Lisfranc? Better question is what…

Written by admin on October 17, 2012 – 3:20 am -

The NFL Injured Reserve has been awash with foot injuries the past two weeks. Cedric Benson, Ryan Kalil and Santonio Holmes all have sustained midfoot injuries, also known as a Lisfranc injury–much more serious than a simple sprain and sometimes requiring surgery.

A Lisfranc injury is an injury to the ligaments and/or bones of the midfoot. This injury can affect one or multiple joints of the midfoot and may include a fracture. Lisfranc injuries are named after Napoleon’s personal surgeon who first described the injury, then common in cavalry officers. The injury was typically sustained when the foot caught in the stirrup and twisted when the cavalryman was thrown from the saddle. Today, football and soccer players are more prone to these injuries because of the twisting and falling mechanisms that occur so frequently in competition.

Symptoms of a Lisfranc fracture include swelling over the top of the foot, bruising on the top and/or bottom of the foot, and pain with weight bearing. Athletes should seek medical attention from an Orthopaedic physician. An x-ray and sometimes an MRI or CT scan will be necessary to determine the alignment of the small bones and joints of the affected foot as well as the integrity of the ligaments.

Non-operative treatment of a Lisfranc injury includes non-weight bearing for 6 weeks in a cast, and progressing to a walking boot for an additional 2-6 weeks. An athlete would not be able to return to athletic competition until he is able to complete sport specific drills without pain.

If an operation is necessary, as it is for Kalil and Holmes, it can take up to six months for full recovery. With this corrective surgery, the bones are put back into place (reduced) and held by plates and screws, which may require removal at a later date.

Prevention of a Lisfranc injury is difficult especially in physically demanding sports like soccer and football, but it is helpful to wear well-fitting, properly designed and constructed footwear (avoid the Clearance bin). Cleats that are too flimsy and flexible may not be able to properly support the foot, increasing susceptibility to injury.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.

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