I had the pleasure of deciding to slide into 3rd base in the MIT softball league game last Wed. (6/23/04) playing for the library team (Bibliotechs) and promptly sprained my foot.
Actually, it's worse than that (I subsequently learned)... my "Lisfranc's Joint" is out of whack.
I learned from the foot & ankle surgeon specialist at Brigham and Women's Hospital that my "Lisfranc's Joint" has suffered a fleck of bone "avulsed" (pulled off) by the cartilage upon the impact. Basically, it's the foot's equivalent of where the finger bones meet the wrist bones; however it's not up at the ankle (my ankle is fine), instead it's located at the top of your foot's instep. My two bones there aren't lining up the way they should.
The not good news is that this very capable surgeon informed me in pretty much certain terms that a "young person like [me]" needed to have this operated on, so that they can go in and insert a screw or two to hold it together so it heals properly. Not doing so invites arthritis and other unwelcome longer term effects re: bone position, etc.
The impact is along these lines:
- Four weeks (possibly bit more, prob. not) in a non-weight bearing, non-removable cast, crutches-only mobility.
- Then four weeks in a walkable (but not removable) weight-bearing cast.
- Then some amount of time (week or two?) in a walking and removable boot thing (like I have right this minute).
- Finally, at about 3-4 months out, they operate again to remove the screw(s).
[Apparently after that operation it does *not* force you back into casts, boots, crutches.]
I'm scheduled for "day surgery" this Friday morning (July 2, 2004).
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Some Googling about on ol' Lisfranc and his Joint:
Bit heavy medical stuff, but I'll paste in below an excerpt
1. http://www.drjcgraham.com/articles/lisfrancfracture_0201.htm
(.PDF) "MANAGEMENT OF LISFRANC’S FRACTURE-DISLOCATION"
Has some "before & after" photos/xrays
2. http://www.travma.org.tr/dergi/download.asp?volume=9&issue=2&pp=145&ord=16
From 1.:
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"There are many scenarios that can cause these injuries. The prominent role is the locking of the forefoot in a plantar flexed or equinos position with the body and midfoot moving past the forefoot in a shearing force. An example would be locking in the foot on an automobile brake and upon impact of an accident, the human body moving forward onto or below the antatarsals (forefoot).
The key to proper diagnosis is clinical suspicion of this rare injury. ...in some cases shows minimal or no radiographic findings. This is usually diagnosed as a sprain foot. A weight bearing x-ray may allow displacement of the disrupted component of the joint enough to reveal this injury.
WR: That's exactly what it was for me: weight bearing x-ray showed it!
The patient, more than likely, will recall a "pop" sensation as in misstepping a curb. There will exist gross swelling and tenderness at the tarsometatarsal joint. ... The "fleck sign" reveals an avulsion fracture of the second metatarsal base in which the Lisfranc ligament has avulsed(a small bone chip) the second metatarsal base.
Accurate anatomical alignment is a must. The integrity or stability of this joint needs to be repaired. This is tantamount to avoid severe foot problems in later life"
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Lots of fun, for good ol memorable ol summer of 2004, lemme tell ya.