injuries and poisoning
Metatarsal Fractures
Lisfranc Fracture Dislocation
ALisfranc fractureis a complete break in the 2nd metatarsal bone, which connects the 2nd toe to the bones at the back of the foot. ALisfranc fracture-dislocationoccurs when the broken pieces of bone are separated from each other (dislocated). Lisfranc fracture-dislocations usually result from a fall on a foot that is flexed or from severe force. The middle of the foot is painful, swollen, and tender, and the bottom of the foot may be bruised. Doctors typically take x-rays from several different angles, but often, computed tomography is also needed to identify the injury. Typically, people with a Lisfranc fracture-dislocation are referred to an orthopedic surgeon for surgery to put the broken pieces of bone back in place and keep them in place or to fuse the broken bones together. In a Lisfranc fracture-dislocation, the 2nd metatarsal bone is fractured at its base, and the broken pieces may be separated from each other (dislocated). Lisfranc fracture-dislocations usually occur when people fall on a foot that is flexed or when the foot is hit with severe force. This injury is common among football players, motorcyclists, and horseback riders. The 2nd metatarsal is broken near its base, and the broken pieces are separated from each other (dislocated). This injury is called Lisfranc fracture-dislocation. Symptoms of Lisfranc fracture-dislocation may be mild or severe. The middle of the foot becomes painful, swollen, and tender. If the injury is severe, the foot may look short, and the bottom of the foot may be bruised. Sometimes the area feels numb. Lisfranc fracture-dislocation is serious and can result in permanent pain and arthritis. Compartment Syndrome can develop. People may have problems participating in strenuous activities for the rest of their life. X-rays Often computed tomography (CT) X-rays are taken from several different angles, but the injury may be difficult to see. Often, CT is also needed to diagnose Lisfranc fracture-dislocation. CT can provide more detailed, three-dimensional images of the injury. Sometimes, when CT is unavailable, doctors ask the person to stand on the injured foot, and then x-rays are taken. If the bone is fractured, the person's weight causes the bones to separate more so that the space between the broken bones shows on x-rays and the injury can be diagnosed. (See also Diagnosis .) Referral to an orthopedic surgeon Surgery to realign the broken bones or fusion of the bone in the foot People with Lisfranc fracture-dislocation are usually admitted to a hospital and seen by an orthopedic surgeon as soon as possible. Usually, one of the following is required: Surgery (ORIF): ORIF involves putting the broken pieces of bone back in place and keeping them in place with screws and metal plates. Fusion of the bones in the middle of the foot: Fusion is similar to ORIF. The pieces of broken bone are put back into place and held in place, as in ORIF, but they are placed so that the damaged bones in the midfoot can grow together into one solid piece. But these procedures do not always restore the foot to its previous condition. If surgery is not required, a cast is used to immobilize the foot, and people are instructed not to put any weight of the injured foot for at least 6 weeks. 