Question
Dear Dr. Katz,
My husband [healthy 36 year old, no other medical problems] was in a car wreck in February of 2006 and was diagnosed with a lisfranc fracture dislocation.  He underwent surgery [open reduction/internal fixation with pins] right away.  The pins were removed at 8 weeks and he started partial weight-bearing then.  He's had a second and third opinion on the foot and both doctors said the  surgery aligned the joints really well. Now, nearly two years after the surgery, he still experiences pain after a day or working or exercising, and stiffness every morning.  He uses custom orthodics and leads a very active lifestyle [although running causes him significant pain].  We've read a lot about joint fusion, and I was wondering what you think of this option? Specifically, what are the success rates of lisfranc fusion and how will it affect his mobility? Will he be able to run again? Thanks very much for your time,

Best,
Sarah

Answer
Hi Sarah,

A Lisfranc Fracture-Dislocation is a very serious injury and often results in long-term pain and arthritis even with the best reduction and fixation.

A fusion is a consideration if the pain is causing daily disruption of normal activities.  First I would consider several types of custon braces which include a Ritchie or Arizona brace.  These are obtained from your podiatrist.

A fusion is a major surgery and does not guarantee relief.  However with a successful fusion and rehabilitation there can be significant relief.  There will be decreased foot function which may transfer stress to the ankle or ball of the foot.  

I would give him a 50-50 chance of running.

I would see a several Drs that perform the fusion on a fairly regular basis and get multiple opinions.  Ask many questions.  Then you can make a decision.

Good Luck.

See the site below:
http://www.thetampapodiatrist.com/document_disorders.cfm?id=212


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com


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