Miami Heat Udonis Haslem Season is Likely Over

Written by Selene Parekh, M.D. on November 24, 2010. Posted in News

The Miami Heat started this season with a lot of anticipation.  Unfortunately, they have a big hurdle in front of them, the loss of Udonis Haslem.  What is the Lisfranc injury and why will Udonis likely be out for the entire season?

ANATOMY

The human foot is composed of 26 bones.  These bones are categorized into the hindfoot, midfoot, and forefoot.

At the junction between the midfoot and forefoot are multiple ligaments.  One of the ligaments, the Lisfranc ligament, runs from the medial cuneiform to the base of the 2nd metatarsal.  This ligament is extremely important in stabilizing the foot.  Injury to this ligament can lead to an unstable midfoot.  If left untreated, the midfoot can collapse, arthritis can develop, and the arch can flatten.

CAUSES

The most common causes of Lisranc injuries are: direct trauma to the foot, loading of the foot while it is pointed down/plantarflexed (see image below), motor vehicle accidents, sports injuries, and fall from heights.

SYMPTOMS

Athletes with Lisfranc injuries will have pain, swelling, and bruising of the foot. It may be too painful to walk on the foot.  Running and cutting activities are very difficult.

TREATMENTS

Athletes with a Lisfranc injury require surgery.  Surgery can be performed in a variety of manners:  with small incisions and screws, or with larger incisions with screws and plates.

WHEN TO SEEK MEDICAL CARE

If you suspect that you have a Lisfranc injury, you should seek medical care within hours of the injury.  A good physical exam, x-rays, and perhaps a CT scan or MRI may be needed to evaluate the foot.

RETURN TO ACTIVITIES/OUTCOMES

Regardless of the type of screws and or plates used, individuals are not allowed to walk on the injured foot for about 12 weeks.  Thereafter, extensive physical therapy and rehabilitation is required.  It is usually 5 to 6 months before running and cutting activities can be started.

VIDEO/ANIMATION

For a video animation of “Lisfranc Fracture-Dislocation”, please see the “Education” tab of my website.  Click orthopaedics, then foot and ankle, then conditions, then ” Lisfranc Fracture-Dislocation “.

It is unlikely to see Udonis Haslem play basketball until May or June of 2011.

Dr. P

———————————————————————————

All material published through this blog/website is for informational and entertainment purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. Dr. Parekh and Duke University will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the discussions in this blog.