So I googled it !

Of course once home, I really needed to know more, in some ways it was reassuring that all of the pain I'd been feeling was for a good reason, but this new information had put a totally different spin on the situation it looked like I was in. So I googled & googled...................

Not all of the info available was pretty, nor was it easy reading, this Lisfranc joint has an important role in our mobility I was discovering. Some of the facts I discovered during my various searches, I've listed below. I decided that it was important for me to fully understand it, to then be able to accept the recovery period it looked like I was going to need.

• The Lisfranc fracture is a fracture of the foot in which one or all of the metatarsals are displaced from the tarsus.
• It is named after 18th- and 19th-century Napoleonic surgeon and gynecologist Jacques Lisfranc de St. Martin.
  Dr Jacques Lisfranc found a novel way of amputating the gangrenous soldiers feet between the mid foot and forefoot. They named the supportive ligament between the two bones in the foot after him, Lisfranc ligament. 
• This injury is usually seen in horse riders whose feet have been stuck in stirrups during a fall, or in people following a fall from height & sometimes in motorists who have been in an accident.
  This is an area of the foot is where you transverse arch is so it is typically very strong and rare to dislocate. 

• Apparently it accounts for 0.2% of all foot fractures.
• The lisfranc ligament is a ligament which connects the base of the medial cuneiform to the base of the 2nd metatarsal. It is injured or disrupted in the lisfranc fracture.
• There are two main forms of treatment, stabilisation & support using a cast followed by gradual mobilisation or surgery followed by immobilisation, & then stabilisation & support using a cast followed by gradual mobilisation

During surgery the location of the surgical incision is dictated by the location of the fracture and joints that are disrupted. If all five locations of the lisfranc joint are disrupted, then two incisions may need to be made on the top of the foot; one on the top inside and one on the top outside. If the first three tarsometatarsal joints are disrupted, then only one incision is made on the top inside aspect of the foot.

Once the disrupted tarsometatarsal joints are located, the dissection is carried down to the involved joints and the debris is cleaned out. The disrupted joints are then repositioned back to the position they were in prior to the injury.  The joints are then fixed with strong screws.  However, if the fragmentation is excessive, a plate may be required. One exception is a disruption of the 4th and 5th tarsometatarsal joints; in this case, the bone is provisionally fixed with wires.  The wires are then removed after about six weeks so that some movement of these joints can be encouraged.

A typical post surgery recovery timeline might be as follows;

• 0-6 (or 8) weeks Post-Surgery.

The patient is non-weight bearing to allow for adequate healing. Not only do the bones need adequate healing, but the disrupted ligaments as well.  The ligaments actually require a longer time to heal.

• 6 (or 8) – 10 (or 14) weeks Post-Surgery.

The patient can being weight bear as tolerated provided the foot is protected in a walking boot, such as a CAM walker.  This boot (characterized by a rigid sole and a rocker-bottom contour) serves to disperse the force away from the middle of the foot and up the leg.

• 10 (or 14) + Post-Surgery.

At the 10-14 week mark, the patient can then transition into a stiff soled shoe.

A displaced injury takes a number of months to recover.  For most Lisfranc injuries about 70% of the recovery occurs in the first 6 months, but it is often a year or more before a patient has reached their point of maximal improvement following a significant Lisfranc injury.

Websites I used & have quoted from here are : www.footeducation.com & Wikepedia.