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Foot & Ankle Problems Message Board

Foot & Ankle Problems Board Index

rta5 -

yes. every lisfranc is different. despite my bad injury, i had a very good outcome of the surgery, mostly because i (extremely) aggressively controlled the inflammation - very key - and had an excellent reconstruction. i have done lots of activity - biking, hiking, climbing over the last 7-8 years. my foot has never felt normal, it's more flat-footed - and my gait has been off through much of that time and i have progressed to a moderate level of arthritis. i had multiple other problems about a year+ ago and spent a considerable amount of time trying to sort those out through a variety of means (problems include plantar fasciitis... straining the plantar fascia in yoga and other activities, tarsal tunnel, metatarsalgia - actually really a distal plantar fasciitis/capsulitis). Overall, much improved with most of these issues gone, several of which i had to self-diagnose and find my own treatment, since the medical community is inadequately broad and creative in its solutions, often (and I am an MD). I am now thinking about getting bone spurs removed from most of the lisfranc junction - especially lateral and first mets. it's my lateral side of my foot that bothers me as that gets irritated, which is harder to treat, and i want to prevent future problems. I'd like to hear from someone who's had such surgery (lateral bone spur removal), but it is v. difficult to find anyone and i am positive i will not find someone with my combo of problems and treatments.

i have been through 8 or 9 orthotics and ignored an achy foot with a mediocre orthotic for many years. after started to get a good grasp of how my gait was off (likely the most damaging of things over many years) i started cranking through 7 or 8 orthotics, until i jerry-rigged my own from the base of an old one which proved the best solution. i was in the process of finalizing the shape before i was going to try to copy it by adding fiberglass to areas i had put athletic tape, etc., and then having it reverse casted - to then recast into a typical orthotic. i then came across a very atypical orthotic, by luck, and that solved most of my difficulties.

if you pursue more treatment - be aware that most (likely all) podiatrists have not been trained in foot biomechanics for that last 15 years. and i can't imagine any orthopedic surgeon has. this is important in determining who to see and what to do after the repair has been done and there are changes over time... perhaps also has some bearing on who does the repair, but ultimately that is most dependent on the individual - experience, technique, and priorities. last - i have doubts about more recent literature recommending foot fusion at the outset if it's a severe dislocation (like ours), although the major benefit is preventing collapse, which i did not have to contend with. fusion may be an inevitable outcome (either by future treatment or naturally - my second metatarsal-tarsal joint auto-fused and it is the least problematic) but it is an irreversible one and such a huge change of foot biomechanics can cause considerably more wear on other joints to compensate. I strongly believe in maximizing mobility (ie - not fusing... but not mobilizing!), correctly supportive orthotics, and shock-absorption in shoes and a few other things to maximize a good outcome. just some of my thoughts - hope they are useful to you and others.

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