Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute left midfoot pain following a twisting injury/axial load to the foot. Reports inability to bear weight, localized swelling, and ecchymosis along the plantar aspect of the midfoot. No history of open wounds or neurovascular compromise.
Clinical Examination Findings
Left foot examination reveals significant edema and ecchymosis over the dorsal and plantar midfoot. Tenderness to palpation localized at the tarsometatarsal (Lisfranc) joint complex. Positive pain on passive abduction and pronation of the forefoot. Neurovascular status: DP/PT pulses palpable, capillary refill <2s, sensation intact to light touch in all dermatomes.
Treatment Protocol
Immediate immobilization in a non-weight-bearing posterior splint. Strict non-weight-bearing status (NWB) for the left lower extremity. Pain management with NSAIDs/analgesics. Referral to orthopedic surgery for definitive management (ORIF vs. conservative). Follow-up imaging (weight-bearing radiographs or CT) as indicated.