Conservative management of subtle Lisfranc joint injury: a case report.
METHODS
Case report.


BACKGROUND
Athletic Lisfranc injuries are characterized by disruption of the soft tissues about the tarsometatarsal joint complex. They are frequently missed on initial consultation due to a paucity of demonstrable physical signs, yet often result in significant disability. This case illustrates the 2 great challenges in managing these injuries: firstly, arriving at an accurate diagnosis and, secondly determining whether the injury is stable and, therefore, appropriate for conservative management


METHODS
The athlete was a 21-year-old professional basketball player with a recurrent ligamentous injury of the Lisfranc joint. A global approach to evaluation and treatment of the entire lower extremity and pelvis in managing this injury is emphasized.


RESULTS
The athlete in this case report made a successful return to his previous level of competition 12 weeks postinjury. At 2-year follow-up he continues to play professionally without any symptoms.


CONCLUSIONS
In selected cases for which patients have no osseous displacement and the ability to run on the toes soon after injury, conservative management of Lisfranc injury may be appropriate Key features of a conservative approach include recognition of a prolonged recovery time adequate rest for soft tissue healing, restoration of a normal gait pattern to prevent chronic overstress of injured tissues, appropriate orthotic prescription, and proprioceptive retraining.
Wadsworth
David J S
DJ
Red Hill Physiotherapy and Sports Injury Centre, Queensland, Australia. d.wadsworth@redhillphysio.com.au
Eadie
Nathan T
NT
D000328:Adult; D001490:Basketball / Q000293:injuries*; D001696:Biomechanical Phenomena; D003937:Diagnosis, Differential; D018409:Foot Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D007593:Joint Instability; D008022:Ligaments / Q000293:injuries*; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D012008:Recurrence; D012420:Running; D013639:Tarsal Bones / Q000293:injuries*; D016896:Treatment Outcome