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The response to the question below was authored by Marc Mitnick DPM
Post-Lisfranc surgery questions
by Brianna
(Mississippi)
2 weeks post-op-Lisfranc surgery
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My lisfranc injury occurred almost five years ago December 21, 2008..i sustained the injury due to misdiagnosis in the beginning and tried orthotics for awhile and the pain just got worse and caused more deformity in the mid-foot region. I went to a well-known orthopedic surgeon in my area who has a lot of experience handling injuries like mine. I finally did my surgery October 7, 2011. During that surgery they did ORIF; fusion of the 1st & 2nd cuneiforms, two metal plates, and 6 screws. They were going to take a bone graft from my heel but there was enough of excess bone at the site that they used instead. Two weeks post-op I went back to the Dr. and he said everything was looking great, my swelling was almost completely gone except for a small amount right around the incisions. Stitches were taken out and I was put into a fiberglass cast for 4 weeks. I am now in that 2nd week, two more weeks and I will be put into a walking boot with partial weight. My foot really doesn't feel all that bad anymore but it just seems like the more the swelling goes away the more I can feel. The metal feels really strange in my foot..tingling and almost movement? I just wanted to know if this is normal to experience strange sensations in early recovery? Will the metal begin to be more comfortable as my foot adjusts? Is most metal put in for these surgeries removed eventually? My doctor says they were in to stay. Maybe it will just take time to get used to. Thanks for your time to listen to my story, hope you might have a little more insight for me.
RESPONSE
Hi Brianna,
Whenever a lot of hardware is placed in a small confined area, like a foot, there always is the chance that
The other problem becomes one where since you will eventually be bearing weight on the foot there is going to be stresses placed on the screws and plates which may also leave you with a "funny" sensation in the surgical area.
Your concerns are generally evaluated on an ongoing basis as it is virtually impossible to tell whether or not you will be left with any residual sensations. Your surgery is only one month old so I would expect you to be having some of the symptoms you describe. What you want to look for is a reduction in these symptoms as time progresses.
It is impossible to state exactly when you will notice this reduction as everyone heals at a different rate. Factors such as your overall health, weight, activity, etc. will impact the healing process.
A general rule of thumb that I tell my patients, is that each month, ask yourself, am I feeling better than I did a month earlier? If the answer is yes, then you are doing fine. If you reach a point where you no longer feel improvement then that might be a cause for concern.
As far as the specifics go, tingling may be due to the surgery, but I should mention there are superficial nerves that run along the top of the foot and sometimes they are either accidently cut or they get caught up in scar tissue causing the tingling that you mention.
As far as movement of the hardware goes, I would raise that question to your surgeon so he or she can check to make sure all the screws are "holding".
In any event always voice your concerns to your surgeon. A good surgeon has no problem answering your questions; that's what they are there for.
Marc Mitnick DPM
DISCLAIMER
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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