8/13/2023 0 Comments Lisfranc fx![]() However, a typical recovery might include: 0-6 (or 8) weeks Post-Surgery Recovery from surgery to fix a Lisfranc fracture, subluxation, or dislocation can vary depending on the severity of the original injury, and the stability of the fixation. Figure 2: Lisfranc injury treated with ORIF, Before (left) and Post-ORIF (right) Regaining flexiility of the outside joints of the foot is important for walking. The wires are then removed after about six weeks so that some movement of these joints can be encouraged. One exception is a disruption of the 4th and 5th tarsometatarsal joints in this case, the bone is provisionally fixed with wires. Depending upon the type of injury and time when being fixed, some joints may need to be put together permanently (fusion). The joints are then fixed with screws, plates with screws, suture based implants, and/or pins (Figure 2). The disrupted joints are repositioned back to the position they were in prior to the injury. Once the disrupted tarsometatarsal joints are identified, the dissection is carried down to the involved joints and the debris is cleaned out. If the first three tarsometatarsal joints are disrupted, then only one or two incisions are made on the top and/or inside aspect of the foot. If all five of the Lisfranc joints are disrupted, then two or three incisions on the top of the foot may be needed one on the top inside and inside border of the foot, and one on the top outside of the foot. The location of the incision is dictated by both the location of the fracture and the location of the joints that are disrupted. In order to treat some injuries, mid-foot fusion may be recommended where some of the joints are permanently placed together. A missed or not treated Lisfranc injury can lead to a loss of the arch of the foot (flatfoot). The purpose of the surgery is to reposition the bones and joints in the mid-part of the foot, allowing the associated torn ligaments (the strong tissues that hold these bones together and support the arch) to heal. The main indication for this ORIF of the Lisfranc joints is a displaced or unstable Lisfranc fracture, or a dislocation. The Lisfranc joints are located in the midfoot (Figure 1). (ORIF is “Open Reduction Internal Fixation” – opening the injured area surgically, reducing the bones and joints to their proper position, and placing screws and plates internally to fix them in that corrected position) Indication
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