Physiotherapy After ORIF for Lisfranc Injury: A Case Report

Abstract

Background: Lisfranc injury treated with open reduction and internal fixation (ORIF) may be associated with pain, edema, restricted ankle range of motion, muscle weakness, and functional limitations. Early postoperative physiotherapy may address these impairments, although individual clinical responses remain insufficiently described.
Objective: To describe early clinical changes during physiotherapy in a patient with Lisfranc injury after ORIF.
Methods: This case report describes a 22 year old woman with a right Lisfranc injury who underwent ORIF and received four physiotherapy sessions between 11 and 20 November 2025. Interventions included soft tissue muscle release, range of motion exercises, isometric exercise, ankle pump exercise, and progressive heel contact practice. Pain, ankle range of motion, muscle strength, foot circumference, and functional status were assessed using the Visual Analog Scale, goniometry, Manual Muscle Testing, circumferential measurement, and the Foot and Ankle Disability Index.
Results: Tenderness decreased from 5/10 to 3/10, movement pain from 3/10 to 2/10, and right foot circumference from 30 cm to 28 cm. Resting pain remained 0/10. Ankle muscle strength changed from grade 3 to grade 4, while ankle range of motion increased across the reported movement directions. The Foot and Ankle Disability Index remained 40%. No adverse events were documented.
Conclusion: Clinical changes in pain, muscle strength, foot circumference, and ankle range of motion were observed during four physiotherapy sessions, whereas functional status remained unchanged. These findings describe one patient's clinical course and cannot establish causal treatment effects or be generalized.