Foot Sprain - Orange County
X-ray showing midfoot sprain of Lis Franc ligament - one of the most commonly missed orthopaedic foot & ankle injuries. Orange County, CA.
Direct Lisfranc injuries in Orange County are usually caused by a crush injury, such as a heavy object falling onto the midfoot, or the foot being run over by a car or truck, or someone landing on the foot after a fall from a significant height.
Even if less serious, there are many causes of foot sprain in Orange County, all of which should be evaluated by a foot and ankle surgeon.
Foot Sprain in Orange County
A midfoot sprain (also known as the Lisfranc) is an injury to the ligaments of the central region of the foot, known as the midfoot. It is a common injury that occurs during athletics, in particular those sports where there is cutting and twisting that can lead to this injury. Our Orange County Podiatrist / Foot and Ankle Surgeon can evaluate and treat your foot or ankle fracture at our Irvine, CA, Huntington Beach, CA, Newport Beach, CA, or Orange, CA offices.
The foot is divided into 3 regions - forefoot (front - toes), midfoot (middle) and hindfoot (back - ankle and heel regions). The midfoot is comprised of five small bones including the 3 cuneiforms, navicular and cuboid. There is a highly complex system of ligaments attaching each of these bones to one another and also to the forefoot and hindfoot. The midfoot is located in the middle of both the transverse and longitudinal arches and forms the apex of each arch. A midfoot sprain can refer to a stretch injury to any of these ligaments.
An athlete with a midfoot sprain will have sustained a twisting or pivoting injury to his or her foot. They will develop immediate pain and later swelling in the central region of their foot. The swelling often can lead to bruising on either the top or bottom or the foot. How much swelling and subsequent bruising occurs is related to how severe the injury is.
The athlete will also complain of pain with bearing weight. In milder injuries they will be able to walk without too much pain, but the higher demands on the foot in athletics will be painful. On the other end of the spectrum, in more severe injuries, the injured athlete may not be able to bear any weight even to walk.
On physical examination, the injured foot will look swollen and be tender over the injured joints. It’s important that the examining physician localize the injury to the specific joints involved. The tendons of the foot should remain intact in a midfoot sprain, however their motion may produce pain in the foot if they place stress on the injured joints with motion.
Treatment of Foot Sprain in Orange County
A mild midfoot sprain can be managed non-operatively with a short period of immobilization in a hard-soled shoe or a removable boot. A short period of limited weight-bearing may be necessary to allow the ligament to heal and therefore the swelling and pain to subside. Regular icing, elevation and non-steroidal anti-inflammatory medications (NSAIDS) are both important to treat the swelling along with the pain. In most of these cases, the athlete will be able to return to participating in their sport in anywhere from a week to a few months.
Surgery for Foot Sprain in Orange County
Rarely, a more severe injury will be unstable and the injured ligament will not be able to hold together the bones as it normally does. In this situation, a surgical repair of the injured ligaments is necessary to avoid chronic pain, swelling and the later development of arthritis. A Lisfranc ligament tear is an example of this type of injury.
In most cases, surgery for foot sprain in Orange County involves a small incision on the top of the foot over the region between the two bones held together by the injured ligament. This is often necessary to be sure the bones are appropriately together (reduced) by direct visualization. The bones are then held together by metal screws or wires in their original position as they were prior to injury. This allows the injured ligament to heal to its original length.
Because the bones of the midfoot have a lot of force transmitted through them during walking and even more during athletics, there is small repetitive motion between them with every step. Therefore, our Orange County Foot and Ankle Surgeon may elect to remove the screws or wires months after surgery to avoid their breaking in the same mechanism as a paperclip that is bent back and forth repetitively.
Please contact our office in Irvine, Orange, Newport Beach, or Huntington Beach in Orange County, CA to make an appointment with our foot and ankle surgeon / podiatrist (Dr. Coyer) to have your foot sprain in Orange County fully evaluated.