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Podiatry/Old Lisfrancs Injury?

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Question
I am a healthy, active 27-year-old mother of a two year old.  In July of 2012, I stepped off the edge of the sidewalk, and rolled my foot on the lateral side of the foot.  I had immediate swelling and bruising over the 1st and 2nd metatarsal.  Radiographs were taken, no fractures, told a sprain and it would heal.  After months of no progress, a new Dr. put me in a CAM boot for 6 weeks.  This seemed to help some, but once out of the boot, was having bruising and pain again.  I went to an ortho dr. (9 months later now) who told me I have a lisfranc injury.  He injected cortisone into the affected area, and I had severe pain and swelling from the injection for days, he told me to stay off of it, and it would eventually heal.  After I returned with same symptoms, he put me in a weight-bearing cast.  I was uncomfortable with this, and then sought a podiatrist's help.  He feels like I dislocated the lisfranc joint in July 2012, and now have postraumatic arthritis.  He suggests surgery to clean the joint and fusion.  He also does not see anything on rediographs.  I am trying not to do CT/MRI because I have no insurance, and most of the doctors I have seen have suggested that it would not change the treatment protocol any.  I am concerned about having a fusion, as most people have more problems with the fusion than is worth the surgery.  I am concerned about loss of mobility in my foot, and continued inability to weightbear normally, as well as concerned I will never be able to wear real shoes again.  I am currently in a CAM boot until I can get into surgery.  My current symptoms are:  bruising on top of foot; lisfranc joints, metatarsal 1 and 2, numbness and/or tingling when that area is touched, inability to wear any arched shoes( all I can wear are flip flops), inability to push a clutch in on a car, inability to walk much at all, every time I step on it wrong, it swells up and bruises worse.  Do you think fusion of the lisfranc joints is a viable option for me?  I understand the posttraumatic arthritis must be dealt with surgically, but am looking for any alternatives to fusion if they are viable options for me.

I appreciate your opinion!

Answer
Dear Jen,

This Orthopedic Chicago Podiatrist located in West Loop 60661,Roscoe Village 60618, Elmhurst 60126 & Bartlett 60103 says...
For your suspected Lisfranc injury-you may have some additional injuries that may not be visible by x-ray. Can't hurt to seek an additional opinion. Then decide on the MRI. In your case-work out a cash deal with an MRI place-if surgery & an MRI continues to be a recommendation. Fusions in that area may have less issues post-op-since there is minimal movement in the midfoot joints of the foot.
Hope this helps.
Good Luck!
The Chicago Podiatrists of AnkleNFootCenters.com are specialists in orthopedics and sports medicine.
We are located in Chicago & Elmhurst

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661


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Dr George Tsatsos

Expertise

All questions related to surgery, orthopedics and medicine of the foot and ankle-Adults and Children. Second Opinion specialist in Foot and Ankle problems including fractures and revision surgery. All questions relating. to foot and ankle problems in children Sports medicine of the foot and ankle Runner's and walking problems

Experience

PRIVATE PRACTICES: Ankle N Foot Center.com, 2220 W Belmont Ave., Chgo., IL 60618 since 1979 Ankle & Foot Center of Elmhurst, 401 N.York Rd., Elmhurst, IL, 60126, since 1989. Physicians Suites, Bethany Hospital, 3435 W. Van Buren, Chgo., Il, 60624, 1980-201. HOSPITAL & SURGICAL AFFILIATIONS: Bethany Hospital, 3435 W. Van Buren, Chgo., Il.- Podiatry staff since 1979-2010 Glen Oaks Medical Center, 701 Winthrop, Glen Dale Hts, IL – Podiatry staff since 1997. Elmhurst Medsurge, 401 N. York Rd., Elmhurst, IL, 60126, since 1999 Resurrection Health Care Surgery Center, 3101 N. Harlem Ave., Chicago, IL, since 1999 Chicago Neurologic & Orthopedic Hospital, 4501 N. Winchester Ave., Chicago, IL, 2008-2010

Organizations
Member of the National & Midwest Academy of Ambulatory Foot Surgery. Member of American College of Sports Medicine. Member of American Medical Athletic Association. Member of Chicago Metropolitan Ski Council.

Publications
Prolotherapy in the Treatment of Foot Problems Clinical Correspondence, June 2002. Vol 92- no. 6 Journal of the American Podiatric Medical Association. Paper on Treatment of Delta-Phalanx of the Foot – submitted for publication to Journal of Foot and Ankle Surgery & for Fellowship of ACPPS., September, 1998 Sports Medicine Consultant for the book-Triathlon 101 Essentials for Multisport Success by John Mora – 1999 ISBN 0-88011-811-3 Windy City Sports – October 1996 Marathon Issue “Keeping Your Feet Happy” American Running & Fitness Association, Clinic Advisor & Lifetime Member – Editorial Staff since 1990.

Education/Credentials
Fellow-American College of Foot & Ankle Orthopedists, since 1991. Fellow-Academy of Ambulatory Foot Surgery, since 1980. Fellow- American Institute of Foot Medicine , since 1987. Fellow-American College of Foot & Ankle Pediatrics, since 1998. Certified in Laser Surgery- by Wenske Laser Center, Ravenswood Hospital, 1991. Certified in Foot and Ankle Arthroscopy – by Doctor’s Hospital, 1991. Certified Preceptorship Director-Scholl College of Podiatry 1993-2006 Board Certified in Foot & Ankle Surgery-A.B.M.S.P., since 1987. Recertified 8/08 till 3/31/2012 Board Certified in Podiatric Foot & Ankle Orthopedics-A.B.P.O.P.P.M., 1991. Recertified 10/2003 till 12/2013 Board Certified in Pain Management-A.A.P.M., since 1990.-retired Clinical Instructor – Department of Medicine at Rosalind Franklin University 10/2007 until present

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