Dolphin’s Ronnie Brown Sidelined for the Rest of the Season with Lisfranc Injury
It was announced this week that star running back Ronnie Brown of the Miami Dolphins is out for the rest of this season with a “lisfranc injury” sustained during their victory over the Tampa Bay Buccaneers last week. Brown was no slouch, running for a team-leading 648 yards and eight rushing touchdowns – the fourth-most in the NFL at this point in the season. Lisfranc injuries in the NFL are not uncommon, and have recently also threatened the careers of Dwight Freeney of the Indianapolis Colts, Kevin Jones of the Detroit Lions, and also Larry Johnson of the Kansas City Chiefs.
Typically, a Lisfranc injury occurs when there is a severe twisting force on the joints connecting the forefoot and midfoot. The forefoot is stuck in place as the force of the athlete’s weight twists around the fixed forefoot during a sudden change in direction on the field or with a tackle. Another mechanism in offensive lineman results from a direct blow compression injury through their foot while blocking an opposing defender. Lisfranc injuries can tear ligaments between the forefoot and midfoot bones, fracture the bones themselves, or have a combination of both injuries.
Lisfranc injuries are usually diagnosed based on the athlete’s description of the injury mechanism and the physical examination. There is typically severe pain in the midfoot region and an inability to bear weight on the foot. Swelling and bruising often occurs and may even become evident on the bottom of the foot. On a physical exam, the injured athlete will be tender over the midfoot and painful to motion passive motion at the midfoot and forefoot junction.
A Lisfranc injury is serious and can be career threatening for elite athletes if it is not recognized and appropriately treated. Failure to restore the anatomy can result in chronic foot pain and secondary arthritis of the involved joints. If there is any displacement of the bones or associated fractures in this region, surgical fixation is usually necessary to restore normal anatomy and increase the likelihood of predictable healing.
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