Left untreated, this little-known foot injury can lead to serious long-term problems
Elite athletes like NFL quarterback Matt Schaub and wide receiver Santonio Holmes had productive seasons ended by the little-known and often overlooked Lisfranc injury, a serious foot injury that few have heard of and no one wants. But foot and ankle surgeons at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons (ACFAS) this week are evaluating how to effectively diagnose and treat this injury, which can result in severe long-term complications like chronic pain, osteoarthritis and even foot deformities.
Relatively uncommon, found in only 1 of every 55,000-60,000 people annually, Lisfranc injuries occur in the midfoot – where the long bones leading up to the toes (metatarsals) connect to the bones in the arch (tarsals). “The Lisfranc complex is a critical joint in propulsion during walking and running. Unfortunately, injuries there are easily overlooked. As many as thirty percent of Lisfranc injuries are missed at initial diagnosis by providers who are not foot and ankle specialists. The long-term effects can be debilitating,” observes Cleveland, Ohio foot and ankle surgeon Mark Hardy, DPM, FACFAS, and a conference presenter.
Diagnosis can be difficult because the signs, even during examination and imaging, can be extremely subtle. Injuries most often occur to car accident victims where the foot is jammed into the floorboard or to athletes when the foot is planted and twisted. Direct trauma injuries can result when a heavy object is dropped on the foot. “Most people don’t have an appreciation of the amount of force required to disrupt the Lisfranc complex. Whether you’re an athlete or a laborer, early and appropriate treatment is mandated,” says Hardy.
Lisfranc injuries can also result simply from missing the last step on the stairs; even a minor slip and fall can cause serious injury. Symptoms of a Lisfranc injury may include swelling of the foot, pain throughout the midfoot upon standing or during examination, inability to bear weight, bruising on the bottom of the foot in the arch area, and an abnormal widening of the foot, possibly signaling dislocation.
Lisfranc injuries fall into three categories; sprains, fractures and dislocations. Sprains typically do not require more than rest and recuperation time, as they are comparable to ankle sprains. In a fracture, a break in a bone in the Lisfranc joint occurs. In a dislocation, the bones are forced from their normal positions. In severe cases, both fractures and dislocations occur. In fractures and dislocations, surgery is often the best option. Patients hope for a non-surgical response, but foot and ankle surgeons are well aware of the dangers associated with putting off necessary surgery.
“A number of factors impact the surgeon’s decision on treatment options; the patient’s age, overall health and activity level,” says Hardy. “Because of the possible long-term impact of this injury, our chief objective is ensuring a positive outlook for the future.”
Wires, pins and even surgical buttons can be used to stabilize the joint, both permanently and in some cases temporarily. Some promising studies have focused on the effectiveness of a minimally invasive technique that can help reduce the recuperation period.
“Lisfranc injuries can be successfully treated when properly diagnosed and treated in a timely manner. If you have experienced any sort of foot trauma and symptoms appear, it’s time to see a foot and ankle surgeon,” urges Hardy. “Especially in the case of Lisfranc injuries, the earlier someone visits a foot and ankle surgeon, the greater the likelihood of a positive outcome.”
For more information on foot and ankle injuries and conditions, visit the ACFAS patient education website, FootHealthFacts.org.
The American College of Foot and Ankle Surgeons is a professional society of over 6,800 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer website, FootHealthFacts.org.
Local nonprofit seeks qualified patients to receive medically necessary surgery at no cost
Dr. Kevin Petersen, and Kelly Petersen, co-founders of Helping Hands Surgical Care (HHSC), a 501 (c) (3) non-profit organization whose mission is to fund and facilitate surgeries for uninsured Nevadans without the means to pay for medically necessary surgeries, announce the second annual Charity Surgery Day, Nov. 13, 2012. HHSC doctors will provide 10 free surgeries that day to uninsured Nevadans without the means to pay and who do not qualify for government assistance through plans such as Medicare.
Dr. Petersen, a board certified general surgeon who has practiced for more than 26 years, along with his wife, Kelly, HHSC’s unpaid executive director, launched HHSC last year to end chronic pain and suffering for Nevadans with no other options. Since the organization’s inaugural Charity Surgery Day on Nov. 15 last year, HHSC has performed 24 free surgeries for uninsured Nevadans.
HHSC is seeking patients who may qualify to receive medically necessary surgery at no cost on Charity Surgery Day. Applicants must qualify both financially and medically and are screened via an advisory panel comprised of medical professionals.
Qualified patients must have a stable, chronic, non-emergency condition that requires surgery to restore a disabled patient to normal function or to remove a potentially life threatening condition, such as hernia repair, gall bladder removal, select gynecological surgeries, select back surgeries and cataract removal. Candidates must reside in Nevada, lack medical insurance and the resources to pay for surgery. They must also be acceptable surgical candidates. To review patient eligibility requirements and apply for surgery, visit www.HelpingHandsSurgicalCare.com and click on the How to Apply link.
In addition to Petersen, doctors working with HHSC include Allan Stahl, M.D., cardiology, Michael Verni, M.D., urology; Cameron Earl, M.D., plastic surgery; Jeannie Khavkin, M.D., otolaryngology and facial plastic surgery; Yevgeniy Khavkin, M.D., spine surgery; Ronette Cyka, M.D., gynecology; and George McMickle, M.D., ophthalmology and eye surgery. Medical District Surgery Center, has once again committed to donating the use of operating rooms on Charity Surgery Day.
“This past year has been one of the most gratifying in my entire career,” said Dr. Petersen, who has personally performed several of the organization’s free surgeries over the past year. “Helping people to get back their lives, to go back to work, to restore their ability to provide for their families and to start enjoying life again, is incredibly rewarding and reminds me of the reason I practice medicine,” said Petersen. “The spirit of HHSC has caught on in the medical community, and we are grateful for the other doctors who have willingly joined our program. It is truly a team effort that takes members of the entire medical community working together to make a difference.”
While all participating doctors waive their fees, surgery isn’t free. Costs such as lab fees, anesthesia, prescription, nurses and surgical techs must still be paid.
To volunteer to provide medical services, to make a donation that covers hard costs of surgery, or to inquire about patient qualifications to receive charity surgery, call 702-242-5393 or visit www.HelpingHandsSurgicalCare.com.
About Helping Hands Surgical Care
Helping Hands Surgical Care is a 501 (c) (3) non-profit organization whose mission is to fund and facilitate surgeries for uninsured and underinsured individuals without the means to pay for medically necessary, quality of life surgeries. Founded by Dr. Kevin Petersen of Las Vegas, Nevada based No Insurance Surgery, Helping Hands Surgical Care values the health and well-being of each individual regardless of their ability to pay. The organization is guided by its focus on the physician-patient relationship and its dedication to transforming and improving the lives of those it serves. For more information, visit www.HelpingHandsSurgicalCare.com or call 702-242-5393.