Dr. Selene Parekh
Texans Matt Schaub Out for Season with Lisfranc Injury
Sunday, during the win over the Tampa Bay Buccaneers, the Houston Texan quarterback, Matt Schaub, injured his foot. Today it was discovered that he sustained a Lisfranc injury. What is the Lisfranc injury and why will Schaub be out for the entire remaining 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 2ndmetatarsal. 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
Schaub will be out for the rest of this season. He should be ready for pre-season play in the summer of 2012.
Dr. P
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