I Hate Anne Frank's Evil Sister

What do I have against Anne Frank's sister, you ask? Well, nothing really. I'm willing to bet the poor girl didn't even have a sister, but I could be wrong (it's been far too many years since I've read her diary). The reason I've gone off on this Anne Frank tangent before even beginning my story is because I recently added some new terminology to my dictionary: Lisfranc. Um, what? So the reference to Anne Frank is because if I tell someone about Lisfranc, it sounds like I'm talking about a girl with the given name of Liz and the surname of Frank. Quite the contrary. Lisfranc refers to a war surgeon named Jacques Lisfranc. "The Lisfranc joint, or tarsometatarsal articulation of the foot, is named for Jacques Lisfranc (1790-1847), a field surgeon in Napoleon's army. Lisfranc described an amputation performed through this joint because of gangrene that developed after an injury incurred when a soldier fell off a horse with his foot caught in the stirrup" (quote taken from here). So why is this important, you ask? Well, On July 4, 2011, I was (un)fortunate enough to receive a Lisfranc fracture to my left foot.


Let me give you the breakdown:

• The Lisfranc fracture accounts for less than 1% of all fractures. Good job Ryan, you must be so proud of yourself.
• It is commonly seen in FOOTBALL PLAYERS. In other words, this is a high energy break, and I might as well have been tackled during the Super Bowl (would have made for a better story anyway).
• To explain the break in simple terms: My first metatarsal (aka the bone connected to my big toe) has become detached by 3 mm (2 mm is the maximum allowable before operative surgery is required) from the rest of the metatarsals. The only way to get the bone back in the correct position, and allow the torn ligament to heal, is to surgically insert a screw.
• Surgery is required, or else my whole foot will collapse. Nice.
• Recovery time: 6 months to a year with a high chance of later developing arthritis. This bundle of joy is here to stay.

How it happened:

How did this happen, you ask? On July 4th, 2011, I was invited to play Ultimate Frisbee with some friends at Poston Junior High School in Mesa, AZ. "Wow, this is going to be a cool, heat of the moment, he hurt his foot while doing some cool move" type of story. Wrong. As I pulled into the area I had planned on parking in, I decided I wanted a shady place to leave my truck (it's REALLY hot in Arizona in July - a good parking spot is determined by the amount of shade, not the distance one must walk). There was plenty of parking near an open gate that would lead me to the field where we were to play Ultimate, but no shade. I drove up about 100 feet or so and found my prime parking estate, right under a huge tree. It was sure to stay shady for the duration of my time there. I decided the open gate was too far away to walk to (in hindsight, it wasn't...) and chose instead to hop a chain link fence that was no taller than 4 or 5 feet. As I went over, the right leg of the shorts I was wearing got caught on a piece of the chain link at the top of the fence and caused me to lose my balance. I made it over the fence, but not the way I had intended. Since my right leg was still stuck at the top of the fence, and the laws of gravity didn't take a break at that precise moment, my left foot took the brunt of the 245-pound force that was destined to return to earth. I immediately felt a sharp pain, as if I had sprained or broken my ankle. The area toward the outside top of my foot began to develop a huge blue spot (blood that had been released by the torn ligament). I was unable to walk at that point, and the rest of the day kept the foot elevated.

Now What?

So a week went by and I decided just to ice it and keep it elevated. In that amount of time, no noticeable improvement was made. At the time, I thought I didn't have insurance, and was starting to get nervous about my predicament (I later found out that I did have insurance, but that's a whole other story you don't care to hear). For the time being, I went to my old physical therapist and asked him to look at it for me (in a pro bono sort of way). Since I developed a good rapport with Dr. Thomas Farnsworth during the time he was working on a back injury, he had no problem pushing a favor my way. He worked on it and strongly recommended I see a doctor. Upon a doctor's visit, and after some X-rays were taken, he had a strong inkling that this was a Lisfranc fracture (THANK YOU SO MUCH FOR YOUR HAUNCH - the earlier this injury is detected and corrected, the higher probability of complete recovery, we're talking hours up to a maximum number of days). To confirm, the doctor ordered an MRI, which was performed the following day. The MRI radiologist confirmed the suspicion of a Lisfranc fracture, in which case I was immediately referred to Dr. John Nassar, M.D., an orthopedic surgeon (one of the best, the hospital staff told me).

Confirmed Lisfranc diagnosis and next steps

Dr. Nassar informed me that he was going to put a screw into my foot to correct to problem, and allow for the ligament I tore to grow back properly. The surgery would be the following Tuesday (this appointment was on Friday). This would be my first major surgery. Let me just put a plug here and affirm that I still have not broken a bone in my body. This injury is a torn ligament - no broken bones (glad I still hold that record). The surgery went smoothly and happened on July 19. It lasted about an hour and I woke up about an hour after it was over. I had a giant elephant cast on my left foot for a week until my follow-up visit.

Today (or rather yesterday, since midnight passed), the elephant cast was removed and my permanent cast was put on. The doctor gave me the choice to leave with just a boot, but I told him I would do whatever he thought was most prudent. He casted my foot and promised that it would be removed at my follow-up appointment in two weeks (not bad, considering some people have to wear hard casts for many more weeks).

Over time, I will continue to document my journey on the Lisfranc fracture path. I know it's going to be long and difficult, and sometimes depressing. Prior to my injury, I enjoyed hiking, swimming, playing Ultimate Frisbee, and most importantly, running 3 miles about 3 times a week, regularly. At this point, I'm extremely worried that my foot will never be the same. I'm worried that the things I love will be difficult, even painful for the rest of my life. But I remain optomistic that I can work through this and have a positive outcome. I've read multitudes of stories on the Internet about Lisfranc, and not too many of them have a positive outcome. I'm hoping that my blog can be host to a success story...