week 12 · last reviewed 2026-08-09
Lisfranc surgery recovery: week 12
Clinical procedure: Lisfranc injury surgery (fixation or fusion).
what's typical at week 12
Is pain at week 12 of lisfranc surgery recovery normal?
typical pain · week 12
Across published cohorts, typical pain around week 12 of lisfranc surgery recovery sits at 3.6/10 (range 2.8–4.4). This week was measured directly in the cited cohort. 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.
Measured week · 1 study · Pain and midfoot function after joint-sparing suture-tape augmented Lisfranc fixation (n=58, mean 16.9-month follow-up) (retrospective case series)
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.
documented at this week
This week
The first twelve weeks follow a set sequence
In a case series of surgically treated Lisfranc injuries, the first two weeks were splinted and non-weight-bearing, then a bivalved cast kept that non-weight-bearing status until a six-week x-ray cleared the switch to a walking boot with weight-bearing as tolerated. A second x-ray at twelve weeks was the point where hardware removal was typically discussed.
This week
The stretch that ends in full activity
In a cohort of 73 people, 32 treated with fixation and 41 with fusion, the protocol was the same for both operations: no weight for six weeks, then partial weight in a walking boot, then full activity by four to five months after surgery. Four to five months is roughly week seventeen to week twenty two, so this window is the run-up to that point rather than the finish itself.
What's typical
Wound infection differs by how the surgery was done
In a matched analysis of 1,100 people per group, surgical site infection within 90 days was recorded in 2.1 percent after open fixation and 4.5 percent after percutaneous treatment. Transfusion was also less common after open fixation, at 1.0 percent against 2.1 percent.
What's typical
Whether hardware comes out depends on the operation
Across a 25-study meta-analysis of ligamentous Lisfranc injuries, hardware removal happened in 86 percent of patients fixed with open reduction and internal fixation, compared with 22.5 percent after primary arthrodesis and 0 percent after flexible fixation. Whether that later removal phase happens at all tracks closely with which surgery was done.
What's typical
Reoperation odds differ sharply by procedure in bony injuries
In a randomized trial of tarsometatarsal fracture dislocations, the bonier end of the Lisfranc spectrum, 78.6 percent of the screw and plate fixation group went on to a planned or unplanned second surgery, compared with 16.7 percent of the primary fusion group. Physical function scores on the SF-36 and SMFA questionnaires did not differ significantly between the two groups through 24 months, and satisfaction ratings matched at an average of 53 months.
The pattern
Pain drops fastest in the first three months
In a group of 58 people who had joint-preserving surgical fixation for a Lisfranc injury, average pain on a 0 to 10 scale fell from 5.3 before surgery to 3.6 at 3 months, 2.2 at 6 months, and 1.5 at 12 months. Most of the drop happens early, with smaller, steady gains continuing through the rest of the first year.
The pattern
Midfoot function keeps climbing through year one
In the same group of 58 people, AOFAS midfoot function scores, on a 0 to 100 scale where higher is better, rose from an average of 28 before surgery to 69 at 3 months, 80 at 6 months, and 90 at 12 months. Function continues building well past the early weeks, not just in the first quarter.
Coming up
Six weeks off the foot, full activity by four to five months
In a comparison of Lisfranc ORIF and primary arthrodesis, both groups stayed off the operated foot for six weeks before moving into a boot for partial weight-bearing, then reached full activity by four to five months after surgery, roughly seventeen to twenty two weeks. The same timeline held whether the surgery was fixation or fusion.
Coming up
Weight-bearing arrives around week seven, give or take
In a series of 15 people treated with a suture-button device, the average time to weight-bearing as tolerated was 6.6 weeks, with a spread of about 2.2 weeks either side. Protocols name six weeks as the target, and the measured average lands close to it, so arriving a week or two later than the protocol week is inside the ordinary range.
Coming up
In ligamentous injuries, hardware removal timing varies widely
In a group of 39 feet with purely ligamentous, stage two Lisfranc injuries, hardware removal happened at an average of about four months after surgery, roughly seventeen weeks, with individual cases ranging from about twelve to thirty two weeks. Two out of three people in this group ended up having that second procedure.
Coming up
Return odds track the injury more than the surgery
Pooling 441 athletes and active-duty personnel with low-energy Lisfranc injuries across multiple studies, 86.16 percent returned to play or duty. The split ran along injury type rather than surgery choice: 95.8 percent of purely ligamentous injuries returned versus 82.1 percent of bony injuries, and mean time missed was longer after operative treatment, 116 days, than after non-operative treatment, 58 days.
Back to work
Return to work or play averages fourteen weeks
In the same series of 15 people, the average time to return to work or play as tolerated was 14.1 weeks, with a spread of about 3.6 weeks either side. That places the middle of the range at roughly three and a half months, and the wider range from about ten weeks to eighteen.
Back to work
The harder injury returned to work sooner, not later
In a prospective study of 32 people, all 21 with high-energy injuries had resumed their pre-injury work by six months, while 3 of the 11 with low-energy injuries had not. Pain at six months told a similar story: the high-energy group fell from 8 to 2 on a 0 to 10 scale, the low-energy group from 6 to 3. Severity at the moment of injury does not settle where you finish.
milestones around now
- 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)
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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