Dodging a Bullet: Darren McFadden Recovers from Lisfranc Injury

Dr. Nick Chicoine – Apr 6, 2012

Gentlemen, we can rebuild him, we have the technology!  Darren McFadden suffered a Lisfranc foot injury during week seven of  the 2011 season while playing against the Kansas City Chiefs.  What seemed like a minor inconvenience, was eventually declared a season ending injury, and ironically is the perfect anecdote for Raider’s 2011 season.  Coach Dennis Allen said he’s heard good things from the strength and conditioning coaches this week regarding McFadden.  Allen stated. 

"I am told that he's back and ready to go,"

Why is it called a Lisfranc injury?

The Lisfranc joint is named after Jacques Lisfranc (1790–1847), a field surgeon in Napoleon's army. He became well known for amputating the foot at the junction of the end of the foot (the forefoot) and the midfoot. He routinely performed such amputations in less than one minute for treating gangrene in Napolean’s soldiers which at the time, before the invention of antibiotics, could be life threatening. Injuries to this region in athletes first became recognized in horseman when they would fall from their horse with their foot remaining in the stirrup. This causes a substantial twisting injury to the ligaments of Lisfranc’s joint.

Why did it take so long to diagnose as “Lisfranc?”

The incidence of Lisfranc joint fracture–dislocations is one case per 55,000 persons each year.  These injuries account for less than 1 percent of all fractures.  As many as 20 percent of Lisfranc joint injuries are missed on initial X-rays.  In McFadden’s case they took a while to definitively come out and admit to it being a “Lisfranc” injury.  This would indicate they had to rule out, turf toe, fractures, tendonitis, and basically any other foot injury before they came to the Lisfranc conclusion.  Regardless of whether the medical staff knew initially the extent of the injury, or they diagnosed it later only indicates a better recovery for Darren McFadden.  If it was SEVERE, there would have been no question on X-ray, and McFadden would have required surgery.

Why is surgery a bad thing in this case?

The fact that McFadden’s foot did not require surgery only meant that the ligaments were not torn.  Had the ligaments in his foot torn, the joint dislocated, or the bone fractured, his prognosis would have been much less promising.  This injury is rare, and because that part of the foot is very strong, when it’s injured, it’s always fairly serious.  My point being, the Raider Nation dodged a bullet because it could have been MUCH worse and possibly career ending. 

How can McFadden Prevent this injury from re-occurring?

/articleimages/mcfaddeninjury1.jpg/articleimages/mcfaddeninjury2.jpg/articleimages/mcfaddeninjury3.jpgMcFadden stated that he will not be changing his style of running, nor do I believe he should.  The way this injury occurs is when the foot is planted while twisting.  In McFadden’s case the injury occurred because of the way he was tackled. Ultimately his style of running had little to do with the injury.  Honestly it could have happened to anyone tackled in the same manner.  

Given the rarity of the injury in general I don’t expect there to be a high chance of re-injury, but then again never can I recall a running back like Darren McFadden sustaining this injury.  It’s a great sign that he is participating in regular off-season training activities.  Luckily for McFadden he has the entire off-season to get comfortable running competitively again.  The extra time will only lesson his chances of re-injury. 

It feels good to welcome back Darren McFadden to the Raider Nation, because we certainly missed him, and with the departure of Michael Bush, we certainly need him now more than ever.  Here’s hoping the new Nike Uniform Shoes have sufficient arch support!  

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