lisfranc fracture or sprain?
I was diagnosed with a severe sprain to my lisfranc joint 6 weeks ago, which I did falling down a staircase (doing the splits-injured foot was toes down during the fall).
The Dr. said there was no fracture evident in the non-wt bearing x-ray.Six weeks later, after adding weight and reducing crutches as per Dr., I still could not walk on the foot except carefully and with pain, on the outside edge only. Even bed blankets hurt.
I had a bone scan that was very hot through the entire Lf joint and a spot on the ankle bone. Dr. still said no fracture based on original x-ray, still has to be a severe sprain, go back to no weight bearing, could take 4 months as I’m kind of starting over again as walking on it as if healing a regular sprain was too abmitious a recommendation.My questions: why won’t he take another x-ray or do a CT if a bone scan is inconclusive at that joint as to whether bone or ligament? He said a hairline fracture won’t show up and can’t be screwed anyway. He said a bigger fracture can’t show up now if it wasn’t there before. He said surgery could be worse in outcome than waiting it out.
I’ve already been on crutches for 6 weeks, to go another 12-16 with basically no treatment, just to see what will happen, seems questionable to me.
3 comments
Vivian Abrams DPM
Did you ask the doctor why a MRI or CT scan was not done?
Lori
No I didn’t. It was one of those discussions where despite my expressing my concerns, I left the appointment feeling misunderstood–as if I were catastrophizing; hoping for surgery or hoping for a worse injury than a “mere” sprain. I can leave him a message re the CT scan.Should I ask for a referral to an orthopedist? I don’t want to be disrespectful. And I certainly don’t want to tell him that my concern is based on my internet research vs. his expertise. I don’t want the surgery if I won’t be able to walk without pain (I’m 44) for the rest of my life. But everything I’ve read says don’t under-treat or under-diagnose this injury and that late diagnosis can give a bad outcome too.
Vivian Abrams DPM
I understand your concern. You should do what you feel is the right thing for you. If you do not feel comfortable, you might ask for copies of your x-rays and get another opinion.