Lynn: I'm Lynn, Dr. Berg's marketing director. And I just got back from a wonderful trip in Cabo. However, on my very last day, as I was leaving, I tripped up a stair and sprained my foot really badly. I knew to put ice on it. And when I got home, I texted Dr. Berg and he said, well, I'll see you on Monday. And so this is a video of his examination of me. So Dr. Berg, what are you, what are you seeing on my foot?
Dr. Berg: Well, besides the swelling of your midfoot, your pain was localized along the third and fourth metatarsals, at the point that it joins the midfoot. And we call that combined sum total of where all those bones join at the mid-foot Lisfranc's joint.
Because people do have a twist and sprain like you did, that torques the foot instead of spraining the ankle, you can see that that whole section could be sprained. And what we worry about are tearing of the tissues called ligaments that join those bones and producing instability. In which case we would see possibly see that instability by a partial to complete dislocation of one of the joints. And the next thing we're concerned about, is any degree of fracture.
So what we do for this injury given that foot has normal alignment and the bones show normal alignment at the mid foot level, is treat it as a sprain of the midfoot Lisfranc's injury without fracture. This is the same treatment as we would use if it did have a small fracture without displacement. And that would be immobilization, which means making it still enough to heal. And it doesn't mean that just because you go in a boot, cast or anything, that it's enough. So sometimes it takes a boot up to the knee and if the pain isn't reducing, crutches would be added. We give it two or three weeks to heal and see if it's improving. Then we make a decision about whether to do physical therapy or graduate back toward your shoes.
Lynn: So I'm relieved at the diagnosis and that there's no break. Instead. I have to wear a boot, which is okay. I can live with that. And I'm just glad it's not July and really sunny out here. Here's the lovely boot that I have to wear until Dr. Berg says, it's okay, to stop wearing it.
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