What is a Lisfranc Injury and Why Will It Keep Matt Schaub Out Of The Game This Season?

News has broken that Houston Texans quarterback Matt Schaub will be out for the remainder of the 2011 season with a Lisfranc injury. I'm fielding many calls asking me about this injury that so many have never heard of and asking what the future holds for Schaub. I thought it would be a perfect time to discuss this uncommon but very serious sports injury of the foot.Lisfranc's Joint

All About Lisfranc Joint
The Lisfranc Joint usually refers to the series of joints that connect the rearfoot to the forefoot. It is also known as the tarsometatarsal joint, since it includes the interface between the bones of the tarsus with the metatarsal bones. The joints and supporting ligaments contribute to the overall stability of the foot, particularly the arch.

How Did Schaub Injure His Lisfranc Joint?
Overall, a Lisfranc injury is an uncommon one. It is however not unfamiliar to the sport of football. A common mechanism of injury when it comes to football players is to have a foot firmly planted in the turf and then suddenly rotate. This can occur if the player is suddenly trying to cut and change directions or is tackled. Since Schaub's injury occured during a quarterback sneak, this is likely the way he injured his foot.

How Do You Know If You Have A Lisfranc Injury?

Types of Lisfranc's InjuriesUsually, after a Lisfranc injury, there is significant pain in the midfoot. In fact, it will be difficult, or even impossible, to bear weight on the foot. Over the next several hours, the pain will increase, along with swelling and bruising.

When you visit your Houston podiatrist to have the injury evaluated, x-rays will be taken. These are often taken while standing, eventhough the foot is painful. It simply is necessary to be able to see the injury. An ultrasound evaluation may also be performed.

If further evaluation is necessary, which it often is, your podiatrist will order an MRI or CT of the injured foot. This will provide a more in depth analysis of the injury and aid the doctor in developing the appropriate plan of care.

What's the treatment of a Lisfranc injury? When will Schaub be back?

If evalution of the injury shows that it is stable, non-operative treatment may be pursued. This generally consists of a period of non-weightbearing and immobilization for 6-8 weeks. Unfortunately, most of these injuries, particularly in athletes, are unstable and require immediate surgery.

Surgery for a Lisfranc injury involves stabilizing the fractures with screws, pins, and plates. This allows the foot to properly heal. After the surgery, the patient remains non-weightbearing for 6-8 weeks. This is followed by physical therapy to restore strength and motion.

There are times when the podiatrist will opt to fuse the joints rather than simply repair them. The school of thought is that this will prevent the injury to the cartilage in the joints to break down and become arthritic. This is a decision that is made based on findings from the imaging studies, the surgeon's expertise, and the activity level of the patient.

When can I return to sports after a Lisfranc injury?

This is the question on every Houston Texans' fan's mind. When is Matt Schaub to return? If the injury was stable and does not require surgery, it is possible for a return to playing in 10 weeks. This is unlikely in Schaub's case.

Athletes of a professional level will require surgery in almost every case. This puts their return to the playing field at 3-6 months after the injury. Unfortunately, the athlete does not always return to their pre-injury form. The injured joints can remain painful and weakened. This injury also can cause traumatic arthritis to set in which can cause ongoing problems.

What do I do if I suspect I have a Lisfranc injury?
If you suspect that you have a Lisfranc injury, time is of the essence! Contact your Houston podiatrist for an immediate evaluation to ensure you get the best treatment. In every case, not treating a Lisfranc injury will cause ongoing pain and problems. Don't let that happen to you!

Dr. Andrew Schneider
Dr. Andrew Schneider is a podiatrist and foot surgeon at Tanglewood Foot Specialists in Houston, TX.