How long are you non-weight-bearing after Lisfranc surgery?

Six weeks is the figure the published protocols agree on. A comparative cohort of 73 people kept both the fixation and the fusion groups off the operated foot for six weeks before moving to partial weight in a boot. An athlete case series splinted the foot for the first two weeks, then used a bivalved cast until a six-week x-ray.

When can you walk normally again after a Lisfranc injury?

Weight-bearing in a boot typically starts at six weeks, and full activity was reached at four to five months after surgery in a 73-person cohort, which is roughly weeks seventeen to twenty two. That was the same for people who had fixation and people who had fusion.

Does the hardware have to come out?

It depends on the operation. Across a 25-study review, hardware was later removed in 86 percent of people treated with fixation, 22.5 percent after primary fusion, and none of the people treated with flexible fixation. When removal happens after fixation it comes at a mean of about 4.43 months in a 482-patient cohort.

Is fusion better than fixation for a Lisfranc injury?

The randomized evidence differs by injury type and this is a decision for you and your surgeon, not a question this page answers. In a trial of purely ligamentous injuries, midfoot function at two years was 88 after fusion against 68.6 after fixation. In a trial of bony fracture-dislocations, second surgeries were far more common after fixation, 78.6 percent against 16.7 percent, yet general function scores did not differ significantly through twenty four months. Pooling five trials and 241 patients, midfoot scores were not statistically different while pain averaged 0.89 points lower after fusion.

Will I get arthritis in my foot after a Lisfranc injury?

A pooled review of 18 studies documented post-traumatic midfoot arthritis in 2.8 percent of people after primary fusion and 17.3 percent after plate-and-screw fixation. Those are rates recorded across the published literature, not a prediction for any one person.

Do athletes return to sport after a Lisfranc injury?

In a pooled group of 441 athletes and active-duty personnel with low-energy injuries, 86.16 percent returned to play or duty. The rate tracked the injury rather than the operation: 95.8 percent for purely ligamentous injuries against 82.1 percent for bony ones. Mean time missed was 116 days after surgical treatment and 58 days after non-surgical treatment.

When can I go back to work after Lisfranc surgery?

In a series of 15 people, return to work or play as tolerated came at an average of 14.1 weeks, with a spread of about 3.6 weeks either side. A prospective study of 32 people found that by six months all 21 with high-energy injuries had resumed their pre-injury work, while 3 of the 11 with low-energy injuries had not. Among 70 service members followed for three and a half years, 80 percent stayed on duty or completed their service.

Why does this page have no pain numbers before three months?

Because no published study reports them. The cohort that measured pain at named timepoints started at three months, so the pain band on this page starts at week 12. Filling the first three months would mean inventing figures, and this site does not do that.

recovery timeline · last reviewed 2026-08-09

Lisfranc surgery recovery timeline, week by week.

Clinical procedure: Lisfranc injury surgery (fixation or fusion).

Typical, evidence-anchored estimate only. It is not medical advice, not a prediction for your body, and not a substitute for your surgeon or clinician.

A Lisfranc injury damages the midfoot, where the long bones of the foot meet the smaller bones behind them. Surgery either holds those joints in position with screws and plates, called fixation, or fuses them, called arthrodesis. The two operations produce different recoveries in one specific way: how likely you are to have a second surgery. Almost everything else about the early months looks the same.

The defining feature of this recovery is how long the foot stays off the ground. Published protocols keep people non-weight-bearing for six weeks before a boot is allowed. That is longer than most people expect, and it is the reason this recovery feels stalled well before anything is actually wrong.

what shapes recovery here

Two things shape the course more than anything else. The first is which operation you had. Across a 25-study review, hardware was later removed in 86 percent of people who had fixation, compared with 22.5 percent after primary fusion. A pooled review of 18 studies also recorded midfoot arthritis in 17.3 percent after fixation versus 2.8 percent after fusion. Neither figure predicts an individual outcome, but they explain why a second procedure is a normal part of the fixation path and much less common after fusion.

The second is whether the injury was purely ligamentous or involved broken bone. In a pooled group of 441 athletes and service members, 95.8 percent of purely ligamentous injuries returned to play or duty, against 82.1 percent of bony injuries. In the same pooled data, people treated with surgery missed a mean of 116 days, against 58 days for those treated without surgery, which reflects the more severe injuries being the ones taken to theatre.

One caveat runs through this whole page. The only cohort that reported pain at named timepoints used a joint-sparing suture-tape technique, not classic screw-only fixation and not fusion. So the pain numbers describe that technique, and no published series reports pain week by week through the first three months at all.

milestone table

Typical milestones

milestone	typical week	range
Non-weight-bearing, splint then bivalved cast	wk 0	Weeks 0-6; splinted and non-weight-bearing for the first 2 weeks, then a bivalved cast holds that status to the 6-week x-ray
Walking boot, partial weight-bearing begins	wk 6	Week 6 in a 73-patient cohort; the same point for fixation and for fusion
Second x-ray check	wk 12	Week 12; the point at which hardware removal was typically discussed in the case series
Return to play or duty (athletes and service members)	wk 17	Mean 116 days missed after operative treatment (about 17 weeks) versus 58 days non-operative; pooled return rate 86.16% across 441 people
Hardware removal, when it is done	wk 19	Mean 4.43 months (about 19 weeks) after fixation in a 482-patient cohort; only some people have it
Full activity	wk 20	4-5 months after surgery (about weeks 17-22) in a 73-patient cohort, for fixation and fusion alike

Table 1 — Typical milestones for Lisfranc injury surgery (fixation or fusion). Each row links to the cited source.

weeks 0–6

Weeks 0-6 · nothing touches the ground

In a case series of surgically treated Lisfranc injuries, the foot was splinted and kept non-weight-bearing for the first two weeks, then moved into a bivalved cast that held the same non-weight-bearing status until a six-week x-ray. A separate comparative cohort of 73 people, 32 with fixation and 41 with fusion, used the same six-week rule for both operations and removed sutures at two to three weeks.

There is no published pain measurement for this stretch. That is a genuine gap in the literature rather than a sign that pain is unremarkable, and this page will not fill it with a number nobody measured. What the protocols do agree on is that the six weeks are not a judgement call about how you feel. They are a fixed period that lets the midfoot hold its corrected position.

wk 0 ·Non-weight-bearing, splint then bivalved cast (Weeks 0-6; splinted and non-weight-bearing for the first 2 weeks, then a bivalved cast holds that status to the 6-week x-ray)
wk 6 ·Walking boot, partial weight-bearing begins (Week 6 in a 73-patient cohort; the same point for fixation and for fusion)

weeks 6–12

Weeks 6-12 · the boot, and the first weight in months

At six weeks the x-ray decides whether a walking boot and weight-bearing as tolerated can start. In the 73-person comparative cohort, people then progressed to partial weight in a boot regardless of which operation they had. A second x-ray at twelve weeks was, in the athlete case series, the point at which hardware removal was typically discussed.

This window contains the largest single change in the whole recovery: going from no load at all to standing on the foot. The published protocols mark the transition but do not record what pain does across it.

wk 6 ·Walking boot, partial weight-bearing begins (Week 6 in a 73-patient cohort; the same point for fixation and for fusion)
wk 12 ·Second x-ray check (Week 12; the point at which hardware removal was typically discussed in the case series)

weeks 12–26

Weeks 12-26 · the first measured numbers, and hardware

Three months is where measurement finally starts. In a group of 58 people followed after joint-sparing fixation, average pain on a 0 to 10 scale was 3.6 at three months and 2.2 at six months, down from 5.3 before surgery. Midfoot function on a 0 to 100 scale, where higher is better, moved from 28 before surgery to 69 at three months and 80 at six months.

Hardware removal usually falls inside this window when it happens at all. In a cohort of 482 patients it came at a mean of 4.43 months, about nineteen weeks. In a smaller group of 39 purely ligamentous injuries it came at a mean of about four months, with individual cases spread between roughly twelve and thirty two weeks, and two out of three people had it done. In the 482-patient cohort, physical function scores after removal were higher than in people whose hardware stayed in, by 5.6 points.

Full activity, in the 73-person cohort, arrived at four to five months after surgery, which is roughly weeks seventeen to twenty two. A separate series of 15 people treated with a suture-button device measured the steps rather than prescribing them: weight-bearing as tolerated came at an average of 6.6 weeks, and return to work or play as tolerated at an average of 14.1 weeks, each with a spread of a few weeks either side.

typical pain · wk 19

Around week 19, the typical band sits at 2.9/10 (range 2.2-3.6). Interpolated between adjacent measured points.

wk 12 ·Second x-ray check (Week 12; the point at which hardware removal was typically discussed in the case series)
wk 17 ·Return to play or duty (athletes and service members) (Mean 116 days missed after operative treatment (about 17 weeks) versus 58 days non-operative; pooled return rate 86.16% across 441 people)
wk 19 ·Hardware removal, when it is done (Mean 4.43 months (about 19 weeks) after fixation in a 482-patient cohort; only some people have it)
wk 20 ·Full activity (4-5 months after surgery (about weeks 17-22) in a 73-patient cohort, for fixation and fusion alike)

weeks 26–52

Weeks 26-52 · slow, real, easy to miss

Between six and twelve months the same 58-person cohort recorded average pain falling from 2.2 to 1.5, and midfoot function rising from 80 to 90. Those are small movements spread across half a year, which is exactly the stretch where people conclude they have stopped improving.

For athletes and service members, this is also the window where return is decided. Across 441 pooled athletes and active-duty personnel, 86.16 percent returned to play or duty. In a separate group of 70 service members followed for a mean of three and a half years, 80 percent stayed on duty or completed their service and 20 percent were medically separated because of the injury.

typical pain · wk 39

Around week 39, the typical band sits at 1.9/10 (range 1.2-2.5). Interpolated between adjacent measured points.

weeks 52–520

Weeks 52 and beyond · the settled result

At final follow-up, at a mean of about seventeen months, the 58-person cohort recorded average pain of 1.2 and placed 53 of 58 people, about 91 percent, in the good or excellent function band.

The long-horizon question is arthritis and further surgery. A pooled review of 18 studies documented midfoot arthritis in 2.8 percent after primary fusion and 17.3 percent after fixation. In the largest fixation-specific cohort so far, 8,101 people, a later fusion was documented in 2.7 percent by five years and 2.8 percent by ten, a rate that barely moved between those two checkpoints.

The randomized evidence comparing the two operations splits by injury type. In a trial of purely ligamentous injuries, midfoot function at two years was 88 after fusion against 68.6 after fixation, and five of twenty fixation patients needed a fusion anyway. In a trial of bony fracture-dislocations, 78.6 percent of the fixation group had a second surgery against 16.7 percent of the fusion group, yet general physical function scores did not differ significantly through twenty four months. Pooling five randomized trials and 241 patients, midfoot scores at two years were not statistically different, while pain averaged 0.89 points lower on a 10 point scale after fusion.

week by week

Open a specific week

A focused read for lisfranc surgery recovery at a single point in time — the typical pain band for that week, the milestones around it, and the documented patterns, each with its source.

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questions

Common questions about lisfranc injury surgery (fixation or fusion) recovery

How long are you non-weight-bearing after Lisfranc surgery?: Six weeks is the figure the published protocols agree on. A comparative cohort of 73 people kept both the fixation and the fusion groups off the operated foot for six weeks before moving to partial weight in a boot. An athlete case series splinted the foot for the first two weeks, then used a bivalved cast until a six-week x-ray.
When can you walk normally again after a Lisfranc injury?: Weight-bearing in a boot typically starts at six weeks, and full activity was reached at four to five months after surgery in a 73-person cohort, which is roughly weeks seventeen to twenty two. That was the same for people who had fixation and people who had fusion.
Does the hardware have to come out?: It depends on the operation. Across a 25-study review, hardware was later removed in 86 percent of people treated with fixation, 22.5 percent after primary fusion, and none of the people treated with flexible fixation. When removal happens after fixation it comes at a mean of about 4.43 months in a 482-patient cohort.
Is fusion better than fixation for a Lisfranc injury?: The randomized evidence differs by injury type and this is a decision for you and your surgeon, not a question this page answers. In a trial of purely ligamentous injuries, midfoot function at two years was 88 after fusion against 68.6 after fixation. In a trial of bony fracture-dislocations, second surgeries were far more common after fixation, 78.6 percent against 16.7 percent, yet general function scores did not differ significantly through twenty four months. Pooling five trials and 241 patients, midfoot scores were not statistically different while pain averaged 0.89 points lower after fusion.
Will I get arthritis in my foot after a Lisfranc injury?: A pooled review of 18 studies documented post-traumatic midfoot arthritis in 2.8 percent of people after primary fusion and 17.3 percent after plate-and-screw fixation. Those are rates recorded across the published literature, not a prediction for any one person.
Do athletes return to sport after a Lisfranc injury?: In a pooled group of 441 athletes and active-duty personnel with low-energy injuries, 86.16 percent returned to play or duty. The rate tracked the injury rather than the operation: 95.8 percent for purely ligamentous injuries against 82.1 percent for bony ones. Mean time missed was 116 days after surgical treatment and 58 days after non-surgical treatment.
When can I go back to work after Lisfranc surgery?: In a series of 15 people, return to work or play as tolerated came at an average of 14.1 weeks, with a spread of about 3.6 weeks either side. A prospective study of 32 people found that by six months all 21 with high-energy injuries had resumed their pre-injury work, while 3 of the 11 with low-energy injuries had not. Among 70 service members followed for three and a half years, 80 percent stayed on duty or completed their service.
Why does this page have no pain numbers before three months?: Because no published study reports them. The cohort that measured pain at named timepoints started at three months, so the pain band on this page starts at week 12. Filling the first three months would mean inventing figures, and this site does not do that.

sources

What this page is built from

Pain and midfoot function after joint-sparing suture-tape augmented Lisfranc fixation (n=58, mean 16.9-month follow-up) retrospective case series · reliability 6/10
Primary arthrodesis versus open reduction internal fixation for acute Lisfranc injuries: systematic review and meta-analysis (18 studies) meta-analysis · reliability 9/10
Primary arthrodesis versus ORIF for Lisfranc injuries: meta-analysis of 5 randomized trials (241 patients) meta-analysis · reliability 9/10
Return to play after low-energy Lisfranc injury: systematic review and meta-analysis (441 athletes and active-duty personnel) meta-analysis · reliability 8/10
Flexible fixation versus ORIF versus primary arthrodesis for ligamentous Lisfranc injuries: meta-analysis (25 studies) meta-analysis · reliability 8/10
Do Lisfranc ORIFs fail? Long-term conversion to arthrodesis in 8,101 patients at 5 and 10 years retrospective cohort · reliability 8/10
Hardware removal after Lisfranc ORIF: timing and patient-reported outcomes (482 patients, 489 feet) retrospective cohort · reliability 8/10
Primary arthrodesis versus ORIF for Lisfranc injuries: comparative cohort with rehabilitation protocol (73 patients) retrospective cohort · reliability 7/10
Ligamentous Lisfranc injuries: hardware removal timing and rate (39 feet, stage II) retrospective case series · reliability 6/10
Outcomes of Lisfranc injuries in active-duty service members (n=70, mean 3.5-year follow-up) retrospective case series · reliability 6/10
Ly and Coetzee: treatment of primarily ligamentous Lisfranc joint injuries, primary arthrodesis versus ORIF (randomized, n=41) randomized trial · reliability 8/10
Henning et al.: open reduction internal fixation versus primary arthrodesis for Lisfranc fracture-dislocations (randomized, n=40) randomized trial · reliability 8/10
Early outcomes of Lisfranc injuries treated with a suture-button internal brace (case series, n=15) case series · reliability 6/10
High- and low-energy Lisfranc injuries: prospective functional outcomes and return to work at 6 months (n=32) prospective case series · reliability 6/10
Lisfranc sports injuries: review of return-to-training and return-to-competition windows narrative review · reliability 6/10
Postoperative complications of percutaneous versus open treatment of Lisfranc injuries (matched, 1,100 per cohort) retrospective cohort · reliability 8/10
Functional outcomes of open reduction and internal fixation for Lisfranc injuries (n=87, mean 4.9-yr follow-up) retrospective case series · reliability 6/10
Mid- and long-term consequences after surgically treated Lisfranc injuries (14 followed, mean 8.3 yr) case series · reliability 6/10
Week-by-week postoperative protocol after Lisfranc fixation in athletes (case series, 10 followed) case series · reliability 6/10

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