A Lisfranc injury involves damage to the bones or ligaments in the midfoot, a region where the five long metatarsal bones connect with smaller bones forming the arch. This area is crucial for stabilizing the foot and transferring weight during movement. When these bones become displaced or the supporting ligaments tear, surgical intervention is often necessary to restore the foot’s normal alignment and stability. This procedure aims to realign the bones, sometimes using internal fixation like plates or screws. Recovery from Lisfranc surgery is a significant journey that requires patience and strict adherence to medical guidance.
Immediate Post-Operative Period
Immediately following Lisfranc surgery, pain management is a primary focus, involving prescribed medications for discomfort. The foot will be encased in a dressing or cast to protect the surgical site and immobilize bones. Most Lisfranc surgeries are outpatient, allowing same-day return home, though complex cases may require a brief hospital stay.
Patients are instructed to keep the foot elevated above heart level to minimize swelling and pain. Applying ice packs regularly to the outside of the cast or dressing, as directed, helps reduce swelling. Strict non-weight bearing on the affected foot is important during this initial period, requiring crutches or a knee scooter. This non-weight bearing phase allows initial healing to begin without disruption.
Managing the Recovery Process
Following the immediate post-operative period, recovery shifts to a sustained phase lasting several weeks or months. Patients typically remain non-weight bearing, or progress to partial weight bearing, as instructed. The type of cast or boot may change as healing progresses, often transitioning from a non-removable cast to a removable walking boot, allowing easier wound care and early range of motion exercises.
If applicable, wound care involves keeping the incision site clean and dry to prevent infection. Swelling and discomfort may persist, requiring continued elevation and ice application. Following activity restrictions, such as avoiding twisting motions or putting weight on the foot, protects the surgical repair. This period establishes the foundation for future rehabilitation, allowing bones and ligaments to solidify initial healing.
Rehabilitation and Return to Activity
Rehabilitation is an important phase in recovering from Lisfranc surgery, to gradually restore strength, flexibility, and balance. Physical therapy typically begins after immobilization and non-weight bearing, around 6 to 12 weeks post-surgery, once healed. Initial exercises may focus on gentle range of motion for the ankle and toes, progressing to strengthening exercises for the foot, ankle, and lower leg. A physical therapist guides progression, ensuring exercises do not overstress the midfoot.
Gradual weight-bearing begins under supervision, starting with partial weight on the boot, increasing as tolerated. Returning to daily activities like walking without assistive devices can take several months, with full unrestricted walking achieved 4 to 6 months post-surgery. Driving may resume once the patient is off pain medication and can safely operate the vehicle, usually when able to bear weight and control the affected foot. Returning to work depends on the job’s physical demands; sedentary roles allow an earlier return. High-impact sports or strenuous activities require a longer recovery (potentially a year or more), and should only be attempted with medical clearance.
Long-Term Outlook and Potential Considerations
Full recovery from Lisfranc surgery can extend for a year or longer, with continued improvements in strength and function. A common long-term consideration is hardware removal. Screws or plates used to stabilize the midfoot might be removed several months after initial surgery, once bones have healed. This secondary procedure prevents discomfort or irritation from hardware, especially if it crosses a joint with motion.
Despite successful surgery, some individuals may experience long-term issues. Post-traumatic arthritis is a recognized complication, leading to ongoing stiffness and pain in midfoot joints due to cartilage damage from the initial injury. Continued monitoring by a healthcare provider and adherence to foot care practices, such as supportive footwear, helps manage these effects and optimize foot health.