teamCSSM - Camberwell Sports and Spinal Medicine
The term “LisFranc Injury” has been in the news a lot this week after speculation into the injury of Collingwood Star Dane Swan in the opening round of the AFL season. It was a gruesome injury with many of the initial reports indicating a fractured fibula. Those in the know however, could see that a fractured fibula was potentially the least of Swan’s concerns.
The foot is a complex arrangement of bony arches and supporting ligaments that underpin many of the foot’s functions. Named after a surgeon from Napoleonatic times, a Lisfranc Injury refers to an injury to any of the nine bones or supporting ligaments of the mid foot (fun fact: there are 26 bones in the foot).
These injuries can be purely ligamentous damage, or they can involve bony structures in the foot in a similar manner to the Swan injury. If bony structures are involved, they are classified as fracture-dislocations. Which explains the concern that this injury may be season-ending for Swan. Most often, Lisfranc joint injuries are high energy injuries that occur when a rotational force is placed on a plantarflexed (toes pointing down) foot but other causes can be more subtle.
Diagnosis of a Lisfranc Injury is not always straight forward and often symptom presentation can be delayed. A Lisfranc injury should be considered when there is mid foot pain and difficulty weight bearing after an acute injury or pain when weight bearing through the forefoot when pushing off or performing calf raises in a more chronic presentation.
The management of a LisFranc injury doesn’t always require surgery and depends on the degree of instability present. There are a range of treatment options that can be utilised to treat a Lisfranc joint injury, including footwear advice, strengthening exercises, mobilisation, immobilisation, taping or orthoses can all be options in less severe injuries before considering surgery.
Whatever the cause, a mid foot injury always needs to be thoroughly assessed and managed as a priority. Here at CSSM, we have a strong team that can assess your injury and advise you of the recommended treatment pathway for you. If you think you are suffering from a Lisfranc joint injury please don’t hesitate to book an appointment with one of our friendly practitioners – we can help you!
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