Hello doctor,
I have been using moon boot from approximately seven weeks, for a fourth base disruption. I have just had x-rays. I would like an opinion on two things, please. Should I be worried about the spacing between the first and second metatarsal (Lisfranc injury)? There does not seem to be any space on the oblique view between the cuboid and the fifth metatarsal. Is that an issue? I apologize for the quality of the photos, and I just was not able to get a better photo of the x-ray. Thank you. I am still in tremendous pain as well as any pressure over my midfoot hurts. The original injury was over eight weeks back.
Hello,
Welcome to icliniq.com.
I have seen the x-ray (attachment removed to protect patient identity).
- I will like to reassure you that the Lisfranc joint, that is the space between the medial cuneiform and the base of the second metatarsal appears normal, and space is within the normal limits.
- The space or lack of it in the cuboid-metatarsal space is just a projection issue.
- Did to have a CT initially? If not, why are you thinking about a Lisfranc injury now? Is it because of persisting pain? Midfoot injuries are notorious for persisting pain because of stress on the ligaments.
For further queries consult an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist
Thank you doctor,
No, I did not take a CT scan. I did have an MRI, which showed the disruption of the capsule of the fourth metatarsal and the cuboid. The surgeon said I was lucky to escape surgery because I had not ruptured the posterior part of the capsule. He did say it was Lisfranc injury, to begin with. I have been non-weight bearing, but only in the boot. However, I have children who have been sick so have occasionally been walking on my foot. There is still some swelling over the midfoot as well.
Hello,
Welcome back to icliniq.com.
- MRI is a sensitive exam and would certainly have picked up a Lisfranc injury at the second base.
- As far as the non-weight bearing is concerned, you have your reasons for not complying fully. But I would not worry too much about that aspect, except to remain smart and not to over do it and in addition, you could bear weight on the heel rather than on the flat of the foot when absolutely necessary.
For more information consult an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist
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