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Lisfranc injury & Rugby

 

Sometimes a mysterious pain in the foot which is hard for professionals to diagnose may be caused by Lisfranc injury. The Lisfranc joint is the point at which the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. This injury is characterized by dislocation or sprain of the Tarso- Metatarsal joint, and occurs when a high energy trauma to the foot is present. This occurs in contact sports such as rugby.

How Do We Know its Lisfranc Joint Injury?

This kind of injury is really very difficult to diagnose because a Tarsal bone fracture is very difficult to differentiate from bone bruising. The symptoms of a tarsal bone fracture and bone bruising are very similar to each other. The signs and symptom of these two disorders are abnormal weight bearing, tenderness, swelling and bruising. X-rays can also present vague results. This is the reason why most of Lisfranc Joint injury diagnoses are not picked up on X-rays.

How Do We Treat Lisfranc Joint Injury?

The treatment of this injury depends on the degree and extent of the injury. A sprain of the Tarso Metatarsal ligament only needs conventional treatment. A removable plastic cast or boot is usually used to immobilize the foot for 4-6 weeks.
To relieve foot pain, a cold compress or reusable ice packs can be applied. Cold compressions are done for no more than 20 minutes every 2 hours.

Reusable hot and cold pack

 

A removable plastic cast allows the rugby player to do regular therapy sessions. Non weight bearing exercises such as pool running with a buoyancy belt can be done when the cast is removed. This allows the therapist to immobilize the ankle joint in order to prevent stiffness of the joint.

Usual weight bearing and mobilization techniques can be done 6 weeks after removing the cast. This is done with the help of a trained therapist. A gradual return to sports activities is advised.

The prognosis is not usually good when there is substantial Tarso- Metatarsal ligament damage. The widening between the Tarso- metatarsal joint present on X-rays causes instability at the Lisfranc joint. This instability predisposes the player to osteoarthritis if the situation happens for a longer period of time. That is why orthopedists advise surgical fixation of the joint that would restore the anatomy of the joint.

Wires and screws aid in bringing the bones back to their original form. The patient is then advised to wear a removable plaster cast for 2-3 months. The patient can gradually return to normal weight bearing activities. However, a particular rugby player needs to discuss with his therapist if the activity is suitable with surgery that requires screws and wires. If these screws and wires are needed to be removed, then it will take another 6 weeks for the bone to heal.

How Do We Prevent Lisfranc Injury

Wearing comfortable and suitable footwear may help the athlete prevent this injury whilst in a rugby game or a training session.

Rugby Rescue Recommends

View Removable cast protection and support for a Lisfranc Foot Injury

 

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