week 52 · last reviewed 2026-08-09
Lisfranc surgery recovery: week 52
Clinical procedure: Lisfranc injury surgery (fixation or fusion).
what's typical at week 52
Is pain at week 52 of lisfranc surgery recovery normal?
typical pain · week 52
Across published cohorts, typical pain around week 52 of lisfranc surgery recovery sits at 1.5/10 (range 0.9–2.1). 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 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.
documented at this week
This week
The long middle of the first year
This is the stretch where change is real but slow enough to miss day to day. In a group of 58 people followed after joint-sparing fixation, average pain on a 0 to 10 scale was 2.2 at six months, down from 3.6 at three months. The distance between those two numbers took five months to cover.
This week
What the settled result looks like
In the same group of 58 people, average pain on a 0 to 10 scale was 1.5 at twelve months and 1.2 at final follow-up, and 53 of the 58 scored in the good or excellent range on a midfoot function score. The figures describe a cohort followed for twelve to twenty four months, not a ceiling for any one person.
Good to know
Hardware removal often comes months after surgery
Among people who had a Lisfranc ORIF and later needed the hardware taken out, removal happened an average of 4.4 months after the original surgery. Physical-function scores recorded afterward were measurably higher than in people whose hardware stayed in place, consistent with hardware irritation surfacing as a mid-recovery setback rather than a lasting one.
What's typical
Most land in the good or excellent function band
Among the same 58 people, followed for 12 to 24 months, AOFAS scores placed 53 of 58, or about 91 percent, in the good or excellent range. A smaller share landed outside that band, a reminder that recovery pace varies even within one surgical approach.
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
Arthritis risk differs by which surgery was done
A pooled review of 18 studies on Lisfranc surgery found post-traumatic arthritis in the midfoot documented in 2.8 percent of people who had primary fusion versus 17.3 percent of people who had plate-and-screw fixation without fusion. Both figures describe outcomes recorded across the surgical literature, not a prediction for any one recovery.
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
Hardware removal averages about four months after fixation
In a cohort of 482 Lisfranc ORIF patients, the hardware that eventually came out was removed at an average of 4.43 months after surgery, close to nineteen weeks. Among those patients, physical function scores measured after removal were higher than scores taken beforehand.
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.
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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