Understanding Lisfranc Injuries and Surgical Repair

By Buffalo Medical Group | February 4 2026 | Uncategorized

By Jack Route, D.P.M. 

Buffalo Medical Group – Podiatry-Foot and Ankle 

A Lisfranc injury is a serious but often misunderstood foot injury that affects the midfoot—the area where the long bones of the foot connect to the arch. These injuries can range from mild ligament sprains to severe fractures and dislocations that destabilize the entire foot. Recently, foot injuries in high-level athletes—such as reports around Buffalo Bills quarterback Josh Allen—have drawn attention to the potential impact a Lisfranc injury can have on performance and recovery. 

What Causes a Lisfranc Injury? 

Lisfranc injuries typically occur when the foot is twisted while bearing weight, or from a direct force applied to the top of the foot. Common scenarios include falls, motor vehicle accidents, and sports-related trauma such as being tackled or landing awkwardly on a plantar‑flexed foot. Athletes are particularly susceptible due to sudden changes in direction, high-impact collisions, and repetitive stress. 

Diagnosing and Treating the Injury 

Early diagnosis is critical. Lisfranc injuries are sometimes missed on initial X-rays, so advanced imaging such as weight‑bearing X-rays, CT scans, or MRI may be required. Treatment depends on injury severity. Stable injuries without displacement can sometimes be managed conservatively with immobilization in a boot or cast and strict non‑weight‑bearing for six to eight weeks. 

However, more severe or unstable injuries often require surgery. 

Surgical Options for Lisfranc Repair 

Surgical repair typically involves either open reduction and internal fixation (ORIF), where screws or plates realign and stabilize the bones, or primary fusion, in which damaged joints are fused together. The choice depends on the extent of joint damage, the patient’s activity level, and long‑term goals. High‑performance athletes, including NFL players, often undergo surgery to restore stability and maximize functional outcome. 

Timeline for Recovery and Rehabilitation 

Recovery from Lisfranc surgery is a marathon—not a sprint. 

• 0–6 weeks: Non‑weight‑bearing in a cast or boot 

• 6–10 weeks: Gradual transition to partial then full weight‑bearing 

• 3–4 months: Physical therapy focusing on strength, balance, and mobility 

• 6–12 months: Return to high‑impact sports or full activity, depending on progress 

Even with optimal treatment, stiffness and arthritis can develop over time, making long‑term management essential. 

A Lisfranc injury can be career-altering if not treated properly. Whether you’re an elite quarterback or an everyday athlete, early diagnosis, appropriate surgical decision‑making, and a structured rehab program are key to a successful recovery. 

Jack Route, D.P.M is a member of the Buffalo Medical Group Podiatry – Foot & Ankle team at 6325 Main Street, Williamsville, New York. Call 716.630.1295 to schedule an appointment for treatment of your foot and ankle concerns.