Midfoot Fracture Surgery

Midfoot Fracture Surgery

Whether you’re an avid athlete or simply had a trip and fall injury, breaking bones in your midfoot is painful. The thing is, this type of injury is sometimes overlooked by patients and shrugged off as only a sprain or strain.

Read on to learn what a midfoot fracture is and how it’s treated:

What is a midfoot fracture?

A midfoot fracture, also known as a Lisfranc fracture, can happen if the bones in the midfoot of one or both feet are broken or when the ligaments are torn. The midfoot is what makes the arch for the forefoot (which are the bones of your toes) and hindfoot bones that include the heel and ankle) to connect.

The midfoot is home to the Lisfranc joint and ligament, which both are vulnerable in a Lisfranc injury. Lisfranc fractures are actually one of the most common foot injuries and can range from mild to severe. This depends on how the midfoot was injured.

What are the symptoms of a midfoot fracture?

The symptoms of a midfoot fracture depend on how severe the injury is. If left untreated, it can cause some very serious complications. As for the symptoms, they might show themselves similar to other types of foot injuries.

A few of the most common symptoms of a midfoot fracture include:
– Pain and swelling on the top of the foot
– Pain that gets worse from walking or standing
– Not being able to walk without help such as a walker or a pair of crutches
– The top or bottom of the foot is bruised
– Your foot is abnormally wider than usual

If you have any bruising on the bottom of your foot, then this may be a sign of a Lisfranc fracture. However, keep in mind that bruising doesn’t happen to everybody.

How is a midfoot fracture diagnosed?

Unfortunately, Lisfranc fractures are often misdiagnosed, so don’t be concerned if you notice your podiatrist taking their time examining your foot.

There are a few ways that doctors can go about diagnosing a midfoot fracture that includes:

Physical Exam

Upon discussing the type of injury and how it occurred, a podiatrist will perform a physical examination of your injured foot. The doctor will begin the exam by looking for any signs of bruising. This is because bruising often indicates what part of the foot was injured and maybe a sign of a sprain, fracture, trauma or a tear in the ligaments. In some cases, a doctor might apply a mild amount of pressure on different areas of the injured foot.

Your broken bone doctor may also have to gently twist and bend your foot to see if you experience pain in your midfoot. A midfoot fracture can cause pain and tenderness in the surrounding area that experienced the injury. You may also have to stand on tiptoes of the injured foot. Standing on the tip of your toes puts a significant amount of stress on your midfoot. You might experience pain from even the mildest injuries, which will help your podiatrist know what they need to look for when you have to do imaging tests.

Imaging Tests

Getting image testing is the best way to diagnose a midfoot fracture. In some cases, a doctor may only need one test while others require multiple before they can recommend treatment. X-rays will show the fracture doctor if any of the bones are broken or the Lisfranc joint complex is misaligned. Your doctor might have to put your injured foot in a certain position to see if there’s any damage to the ligaments and compare them to an x-ray of your uninjured foot.

In rare cases, doctors may require you to undergo an MRI or a CT scan. These tests provide doctors with a more in-depth look of your foot than x-rays can. Furthermore, these tests are actually very common if a case requires surgery.

Treatment for a Midfoot Fracture

There are a few ways to go about treating a Lisfranc fracture. The most basic form of treatment is applying ice, keeping the injured foot elevated and getting rest. Moving around on the injured foot is not advised and should be avoided until it’s healed. In addition, you should always have a doctor look at your foot as soon as you can.

Once they’ve done the examination, they’ll determine if you need one of these two treatment options:

Non-surgical Treatment

If your Lisfranc injury is only a mild injury, such as not having any torn ligaments, fractures or dislocations, your doctor may have you wear a cast for a little while. You’ll have to wear the cast for six weeks at the very least. As this period goes on, you cannot put any weight or pressure can be put on your injured foot. Furthermore, you might need additional x-rays performed to make sure your foot is healing properly. If it’s showing no signs of healing, you might require surgical fixation.

Surgical Treatment

Any injuries to the midfoot that involve a dislocated joint, abnormal positioning or a bone fracture might have to have surgery. Of course, the surgery does depend on how severe the injury is. The most common surgical treatment for a Lisfranc fracture is known as internal fixation surgery. This surgical procedure has to do with adjusting the injured bones back into their proper positions.

Once that’s done, the surgeon will hold them in place using screws, plates or wires. If the surgeon uses plates, they have to remain there until the bones are healed. After your bones have healed, the plates may have to be surgically removed.

Another surgical procedure that may be recommended is fusion. However, this operation is for those who have a severe midfoot fracture. The idea of this procedure is simple; it involves putting the injured bones together so they heal as one. Fusion might reduce the overall motion of your foot, but it’s considered to be one of the best surgical methods when internal fixation won’t help.


If you received surgery, you’ll have to go about six to 12 weeks of wearing a cast. You might also need physical therapy to re-adjust the motion of your foot. As for the recovery, it depends on how severe the injury was and what surgery was needed.

If you sustain a Lisfranc injury, seek out help as soon as possible. Even what may seem like a slight injury can turn into something worse. Contact your doctor and they’ll see if there are any underlying issues.