Lisfranc Injury: First Aid Awareness, Mobility Risks, and Workplace Safety in Canada

A Lisfranc injury affects the ligaments and bones that connect the midfoot to the forefoot. These injuries can involve a dislocation, a fracture, or both, and are often more serious than they first appear. Because the midfoot plays a critical role in weight-bearing, balance, and walking, Lisfranc injuries can significantly impact mobility and safety.

From a first aid and workplace safety perspective, Lisfranc injuries are important because they are commonly missed, frequently mistaken for simple foot sprains, and can lead to long-term disability if not treated promptly and correctly.

This article is intended for education and injury-prevention awareness. It does not replace medical advice or diagnosis.

Understanding the Lisfranc Joint

The foot is divided into three main sections:

Forefoot – toes and long bones leading to the toes
Midfoot – small bones (navicular, cuboid, and cuneiforms) that form the arch
Hindfoot – heel and lower ankle

The Lisfranc joint complex sits where the forefoot and midfoot meet. Strong ligaments normally hold these bones tightly aligned. When these ligaments are torn or the bones fracture, the foot can lose its structural stability.

Why Lisfranc Injuries Matter for First Aid and Safety

In Canadian workplaces and daily activities, Lisfranc injuries are concerning because they can:

Cause severe pain with standing or walking
Lead to loss of balance and instability
Increase the risk of falls
Result in prolonged time off work
Cause permanent foot problems if missed

First aiders should treat midfoot pain after injury as a red flag, not a minor sprain.

Common Causes of Lisfranc Injuries

Lisfranc injuries often occur due to:

An awkward step or twist on uneven ground
Falls
Sports injuries
Motor vehicle collisions
Heavy objects landing on the foot

They are common in both workplace incidents and recreational activities, especially where footing is unstable.

Signs and Symptoms to Watch For

A Lisfranc injury should be suspected if the following are present:

Pain in the middle of the foot
Pain that worsens with standing or walking
Swelling across the top or bottom of the foot
Bruising, especially on the sole of the foot
Difficulty bearing weight

Because swelling and pain may initially seem mild, people may try to “walk it off,” which can worsen the injury.

Why Diagnosis Is Often Missed

Lisfranc injuries are not always obvious on standard X-rays. In some cases:

Weight-bearing X-rays are needed to reveal misalignment
CT scans or MRI are required for confirmation

Many Lisfranc injuries are mistakenly diagnosed as simple foot sprains, delaying proper treatment and increasing the risk of long-term complications.

First Aid Response: What to Do

From a first aid perspective:

Do not encourage walking on the injured foot
Immobilize the foot if possible
Apply cold packs to reduce swelling
Elevate the foot
Refer for urgent medical assessment

Any midfoot injury with swelling and pain after trauma should be evaluated by a healthcare professional.

Treatment and Recovery

Non-Surgical Management

Minor injuries with little or no bone separation may be treated with:

A rigid cast or walking boot
Strict non–weight-bearing for several weeks

Surgical Management

Most Lisfranc injuries require surgery to:

Restore normal bone alignment
Secure the joints using metal screws or fixation devices

Recovery typically involves:

6–8 weeks without weight-bearing
Use of a walking boot during healing
Removal of fixation hardware after several months
Full recovery taking 6–12 months

Severe injuries may result in ongoing pain, stiffness, or arthritis.

Workplace and Daily Safety Considerations

Lisfranc injuries can affect:

Ability to stand or walk safely
Use of ladders or uneven surfaces
Return-to-work timelines
Long-term job suitability in physically demanding roles

Early recognition and proper treatment help prevent chronic foot instability.

Key Takeaways for Canadians

Lisfranc injuries are serious and often overlooked
Midfoot pain after injury should never be ignored
Early diagnosis improves outcomes
First aiders play a key role in recognizing red flags

Educational Disclaimer

This article is provided for general education and first aid awareness only. It does not diagnose or treat injuries. Anyone with midfoot pain after trauma should seek professional medical care promptly.