Lisfranc injury fixation

Stabilisation of the tarsometatarsal joints (lisfranc joint) for unstable injuries

Surgery for the tarsometatarsal joints, when indicated is carried out via an incision over the top of the foot to access the Lisfranc joint. The joint is cleared of any fracture pieces or scar tissue and held in correct position with a clamp.

In some patients a ligament reconstruction technique (InternalBrace) is suitable with certain instability patterns. In others with more severe injuries, plates and screws are required. In very severe, or neglected injuries - these are best treated with primary midfoot fusion

Mr. Talia is always happy to see patients at short notice with foot and ankle injuries and if surgery is required this can typically be organised in a safe manner within recommended timeframes for the best outcome.

Figure 1: ligament reconstruction technique (left) and plate and screw fixation (right).

Figure 2: severe lisfranc injury treated with a primary midfoot fusion

Post-operative plan:

  • Surgery is typically an overnight stay

  • A nerve block of the leg is administered to help with pain

  • 0-2 weeks: elevation at home, plaster cast

  • 2-6 weeks: partial weight bearing in a CAMboot

  • 6-10 weeks onwards: full weight bearing in moon boot

  • >12 weeks: progress to strengthening

Download post-operative care guide

Risks of surgery

  • Swelling, stiffness

  • Infection and wound breakdown

  • Blood clots

  • Scar sensitivity, numbness in the foot

  • Ongoing pain

  • Progression to arthritis of the foot or ankle joints

  • Removal of implants

Nb: in patients treated with plates and screws, this hardware is routinely removed in all patients to prevent breakage and long term problems. This is typically done between 4-5 months after the original surgery.