Understanding your injury

The Lisfranc joints link the midfoot to the metatarsals. Injury can range from a stable ligament sprain to a displaced fracture-dislocation. Midfoot pain, swelling and bruising beneath the foot can raise suspicion. An apparently minor twist can cause a significant injury. Examination and X-rays assess alignment; clinician-directed weight-bearing views, CT or MRI may be needed when the injury is subtle or surgery is being planned.

Treatment and the procedure

A confirmed stable, undisplaced injury may be managed with immobilisation and protected activity, with follow-up imaging to ensure it remains stable. Displacement or instability may require surgery. Options include realignment with plates or screws, or fusion of selected damaged joints. Fusion joins those bones permanently; fixation aims to hold alignment while healing occurs. The best choice depends on the joints involved, cartilage and ligament injury, your health and functional goals.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

Treatment aims to preserve a stable, aligned arch and improve walking. Persistent pain or arthritis can occur even after an apparently successful repair.
Discuss infection, wound problems, nerve symptoms, blood clots, recurrent displacement, nonunion after fusion and metalwork irritation or breakage.
Some fixation constructs require a later removal procedure; this is not automatic for every patient. Arthritis may require further treatment, including fusion. Return to impact sport is not guaranteed.

Rehabilitation and aftercare

Follow the surgeon's written instructions for weight bearing, boot or cast use and permitted movement. Do not walk through midfoot pain or advance loading without approval. Physiotherapy introduces strength, balance and gait work when the repair or fusion is ready. Footwear changes or an orthosis may help during recovery. Swelling and reduced endurance can last beyond early healing; return to work and sport should reflect symptoms, imaging and the demands of the activity.

When to get urgent help

Attend A&E for sudden severe pain or rapidly worsening numbness or colour change. Seek prompt review of fever, wound discharge or a tight cast.
Seek urgent advice for new calf pain or swelling; call 999 for chest pain or breathlessness.

Your consultation

Ask how stability was assessed, why fixation or fusion is proposed, what movement changes to expect and whether metalwork removal is planned. This information supports an individual consent discussion.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Lisfranc injury