Foot dislocation (Lisfranc Displacement)

Well I new I would end up here sooner or later.....by the way it was sooner than expected. Here is the short story of what I believed to have happened and the results with pictures. If you are going to ride the small soft banked turn...COMMIT and stay commited! I didn't stay committed and ran through the small berm and the front tire dug in on the back side which allowed the back of the bike to come off the ground and swing around. My foot was planted and this allowed the back of the bike to fold my toes/front of boot up against my shins. Thus causing the dislocation of all my toes on my right foot and breaking several in the process.

Boots: Sidi Adventure Rain
Pros: Waterproof, Comfortable, great ankle /shin / achilles tendon support mechanism...similiar to ski boot
Cons: None really other than me taking them outside their design parameters and asking them to do everything well....OK thicker sole

The injury: Lisfranc Displacement
Lisfranc was a French Calvary surgeon during the 1800s. The injury frequently occurred during when Calvary solider was shot, and subsequently fell from his steed. More often, his foot was entangled in the stirrup causing the same injury. At that time, the injury would gangrene, causing the loss of most of the leg. Lisfranc realized the severity of the injury (and the vascular compromise) and amputated earlier (and at that point of the foot).

BTW, of all the photos I found of the Lisfranc injuries on the interwebs, I think this one might be the most severe. Most of the photos I saw they had to use arrows and circles to show you the fault....




So all my toes were dislocated in my little dirt bike mishap and need to be put back in place. So they shot my ankles up with some numbing juice, then he tied loops around my two big toes. Guess what happens next......the orderly guy comes in and basically hangs from my foot while the on call Orthopod attempts to muscle the toes back in place, which we didn't know at the time were broken, back into their proper location. Holy Shit did that have me climbing the walls!!!!!! :eek1 We got a few back in place but some of the loose parts, bone chips, prevented him from getting the rest back in place. The Orthopod tried to under play what was going to happen and how painful it was going to be but I knew better.



Standard wristband we should all be issued...maybe I will make a sticker.

So there it is with 3 screws for now...his plan is to take them out if I heal well. He did not have to fuse anything so what little mobility you have in that part of the foot will still exist and less than a 15% of developing Arthritis as he see's it. It is going to be non-weight bearing for months...not happy about that but considering the circumstances I will keep my pie hole shut.

What would I do differently: Stick the turn no matter what and keep the leg up high so it doesn't get mashed from behind by the bike. Look into some boots which may have better sole support which will help cut down or prevent the flexing. Buy boots which are less comfortable, ie walking, and focus on protection in this type of riding scenario. The Sidi Adventure Rains will/have worked in all the other situations well but riding a 2 stroke dirt bike on single track really isn't their forte.

Foot as of 10/01/2012

Foot as of 10/28/2012


Update as of 12/20/2012
Well the procedure went well with no complications. Screws were removed with what seemed like ease so apparently I didn't bend anything. He couldn't get me the screws unfortunately since they were already bagged and tagged. They only gave me a little juice through the IV with the majority being done with a local. The most pain I experienced throughout the procedure was the IV in the back of the hand. So while all this was going on we were having fun, laughing and shooting the breeze with the Dr. and rest of the staff.....great group of folks! The only thing I really felt was the pressure when he was working the screwdriver...no power tools used. So now I am home with my leg propped up, I will provide more of an update later. So bottom line for now is I got past the milestone and moving forward with recovery and life. It was a good day! Thanks for all the well wishes as well and Merry Christmas to everyone!

Update as of 12/21/2012
Decided to forgo the pain pills for a bit to see what I was working with and it looks like 3 to 4 on the pain scale, so not bad but definitely noticeable. Most of the pain is on top where they removed 2 screws from.

Short term limitations
So here is where I am at for now.
Minimum activity for 5 days
No strenuous activity for 4 weeks
Weight bearing as tolerated
Progress back to full weight bearing
Stitches can be removed in 10 days either by primary care doctor or myself, guess which one will be removing the stitches?
Boot for 2 more weeks then start weaning myself off (1 hour regular shoe then 4 hours back to boot)
Change dressings in 6 days and keep stitches covered and don't get them wet.

Carry on with life!

I am figuring 2 to 3 weeks and then I will give the DRZ a try.

One of the last things the doctor did was ask me if I wanted a print out of the X-ray for my thread since a certain someone, J4S, introduced him to my writeup. He actually acted like he was pretty impressed with it and liked my description of hanging me by my toes and the pictures showing it.

January 1st went for my first street ride...a bit early but it's tradition.

February 10th I went for my first single track ride in the woods since the accident...I was a bit worried but I had waited at least long enough to get my foot in real MX boots for maximum protection. A little sore at the end of the day but everything is well the next day.

You forgot the part about riding the bike back to the truck.... :huh

Holy mother of, well...... dang, that just looks effing painful brother.

I busted a bone in my shifter foot a year ago, and it was down about 5 weeks. Still walk a bit stiff with the dang thing.

It's not even a decent appetizer story compared to yours, I am not worthy, hats off, or should I say boots off?

Heal quickly.

Yep...your right I rode the bike back to the truck.

Uuuugh. Feeling queezy.

Dude, glad you weren't hurt worse.

When you get back into rehab, here's a little trick. Every day, sit with your foot propped up and write the alphabet with your big toe (moving everything from the ankle down - write big!). It's a good exercise to rebuild the musculature of the foot.

You should have seen the shades of pale that showed on his face as he was laying there writhing in pain. Sad thing is no one got a picture.

I guess the interesting part for me is that that I am understanding the signs of shock that my body gives me while still having time respond prior to shutdown. That's not one of those things you get from a Cracker Jack box and there is only one way to get the experience.....experience sure has a cost involved.

One of my other experience gathering experiments allowed me to experience my vision turning black and white and my field of view to get very pinpoint.....that little experiment was worth 60 stitches in the leg. Both times It was shock setting in and I was lucky enough to keep it at bay.

Don't stand on the crutches with your weight supported by them against your armpits. Nerve damage can happen.
Use the crutches like your own gym. Come up with exercises to keep the boredom away. Use them to work the abs too!

this all assumes you're non-weight bearing on crutches.

Sounds similar to my crash last week. f800GS on top of my left foot. My Italian boots saved me from more harm. Dislocated big toe, fractured 3 metacarpals. Fractured clavicle. Rode that bitch into the ground. Just washed out the front and bam! Eating dirt. Happens so fast. Heal well, I got a plate, 8 screws and LOL looks like some chicken wire in the shoulder.

Nacho

Nacho.......I wish you the best in your healing process!!

So, thought I'd share a bit of story. It took Blaster 3 medical facilities before he landed somewhere with enough confidence to actually attempt to fix what ails him. Part of the in patient processing, they mark all open wounds and skin defects on the paperwork.

Anyhow when they got to his left arm, they found this:


Naturally, they assumed it was related to his "high-energy event" (as they call it). Didn't occur to them, that this was work of hospital #2 trying to set an IV...twice and still missing!

blaster11,

Ouch! I hope you heal completely and without any lingering issues.

I use Sidi Adventure Rain boots for most of my trips, mostly for the convenience of being able to hike, etc. They are extremely comfortable all-day boots, but as you confirmed, do not offer the protection of a true MX boot. I guess everything is a trade off.

Best,

I will have to give that a try...sounds interesting!

I remember reading about that a long time a go thanks for the reminder.

Called to talk with the doc man today about my meds and possible side effects and ended up with an unexpected trip up to his office in Baltimore. It appears he was a bit concerned about the potential for infection. Well at the end of it all things seem ok but he went ahead and started me on a course of antibiotics. When I got there it was swollen up pretty darn big which concerned them until I explained to them that I had a 2.5 hour car ride, meaning that it had not been elevated. So we took some more X-rays and verified everything was still in place and it was. So only a few things left to do, one of which is to make me climb the walls. I am not one of those who believe in better living through chemistry so I am a bit light on using the pain meds. Ok now with that said doc man grabs my foot and starts squeezing the excess fluid out through the various holes.....HOLY SHIT!!!! I was in need of some pain meds and wanted them NOW!!!!

It's taken several hours and some more meds to get the pain and swelling back under control. I have new bandages and boot which will help a lot in keeping the wound clean and working my joints a bit. It will still be quite some time until it is weight bearing again, doc man was pretty clear about that.

The other funny thing was he took a sharpie and drew a line around the purple swollen part and dated it so we could track progress.

Dude... It is a good thing I just ate. Hang in there buddy and if you need a ride anywhere... Let me know. I'll be Dana's backup. Just got back from Moose trip... I'll post pics on the moy thread. You can lay in the back seat with your foot elevated. :eek1

Doc must have been drinking before surgery, cause he completely missed the stencil marks. JK.

Yep, that's the reason I saved the pictures for Face plant...it's expected over here.

ok...so maybe a stupid question....
but would boots with a steel shank have prevented some of that injury?