Historically speaking there are many reasons to avoid a land war in Asia. For soldiers who served on the Russian front with Jacques Lisfranc de Saint Martin (1790-1847) under Napoleon one of those reasons included dealing with the necrotic tissue severe frostbite left behind. Various sources credit field surgeon Lisfranc with perfecting the amputation that bears his name; reportedly Lisfranc could perform this osteotomy free operation in fewer than sixty seconds.
Roughly twenty-five percent of the bones in the human body lie below your ankles. Each joint works cooperatively to help you stand, walk, run and pivot. Every time you use your feet to extend your height your body is depending on two functional Lisfranc joints. The metatarsals are the long bones of your foot. These connect to three cunieforms and your cuboid bone to form a Lisfranc joint. Without these supporting structures in their proper positions your foot may be unable to bear your weight.
As with any joint complex there are ways to disrupt normal positioning. Fortunately serious injuries to either of the Lisfranc joints are relatively uncommon although 30-something males have a higher incidence of Lisfranc injuries than similarly aged females. Ways to injure Lisfranc's joint are not limited to but include the following: auto accidents, athletic injuries, certain disease states and lastly the unpoetic stepping into a small hole and breaking one or more Lisfranc joint bones.
Due to the arrangement of the bones and the way the injury can present Lisfranc injuries can easily be missed by a normally competent health care professional. If the top of your foot hurts, the pain is accompanied by swelling and you are unable to bear weight or stand on your tiptoes you may have injured one of your Lisfranc joints. Treatment for Lisfranc joint pain depends on the severity of the injury however experts agree that the sooner you are diagnosed and properly treated, the better.
One of the interesting things I ran across when I was researching this writeup was a study where people played around with various ways to insert surgical pins into different surfaces of the Lisfranc joint. The object of the study was to determine whether a medial or lateral bone insertion was better however from what I understood the difference was statistically insignificant. Another site I ran across was even more interesting. That site was a forum for people to discuss their Lisfranc joint injuries.
What was interesting about the forum is most of the people there were discussing the Lisfranc amputation and giving reasons why they wanted to proceed with this surgery. From what I read removing a part of your foot is a major undertaking that your insurance company may not cover. Obviously anyone undergoing this can expect a great deal of pain but from the discussion boards the people considering this procedure are already dependent on heavy duty pain killers or are unwilling to rely on them to get through their daily activities.
If one of your regular activities includes windsurfing or horseback riding know that you run a greater risk of breaking bones in your Lisfranc joint because your feet may remain in one position while the rest of your body is subjected to a great force. Ballerinas are also in the higher risk group although toe shoes are specifically designed to help support the Lisfranc joint. Children who fall out of bed at night sometimes end up being treated for broken Lisfranc bones which is why this break is also known as bunk bed fracture.
Because I am a hopeless romantic I want people to have sound limbs and if they have to have a traumatic injury I want it to heal well without any further complications. Injuries to the Lisfranc joint are not among those that typically heal well so it is in your best interest to avoid traumatizing this area if possible. Certainly none of us can prevent things like stepping into a small hole you didn't see however approximately ninety percent of the amputations performed in the United States of America are surgeries that involve diabetic patients.
The diabetic foot is particularly at risk because over time the bones involved in a Lisfranc joint may separate. This can happen so gradually that the person does not realize their bones are shifting. Diabetics typically have reduced peripheral circulation, this limits the blood supply an injured joint needs to heal. If you are diabetic managing your blood sugar levels is of paramount importance even if Lisfranc injuries are relatively rare.
To summarize up until now your Lisfranc joints have probably been working hard without much attention from you. Maintaining good foot health includes daily stretching, regular weight bearing exercise, a nutritious diet that supports joint function and plenty of water to help flush toxins from your body. My goal in all of the foot writeups is to help educate people; an educated Lisfranc joint owner can try to avoid things that may be potentially harmful. Hopefully these people will seek appropriate medical treatment as soon as they can after any foot injury.
Life on this earth is not always easy. On bad days you can be thankful that you are not a French soldier anticipating the removal of some part of your foot without amenities like antibiotics and narcotics. For those days when you feel like you're doing a damn good job and no one around you is noticing remember that hundreds of years ago a gynecologist named Jacques Lisfranc de Saint Martin probably wasn't thinking that centuries later people would be reading about joints, fractures and amputations named after him.