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Dane Swan’s career-ending foot and ankle injury

It was with much sadness this year that Swan’s career came to an early end after suffering a Lisfranc injury to the mid foot, along with an ankle fracture.

The injury was first described by Napoleon Bonaparte’s surgeon, Jacques Lisfranc de St Martin, who gave his name to the joints and injury of the mid foot. Trauma to the mid foot was common in the Napoleonic Wars, when horsemen were thrown from their mount, and dragged with their foot in the stirrup. Treatment in the day would normally be amputation, as the flail foot would be useless for propulsion.

Fortunately, we have advanced significantly since the early 1800s. A number of players with these injuries make an excellent recovery after surgery and a carefully progressed rehabilitation program. Some subtle injuries can even be managed with non-operative means including a Camwalker boot. However the severe (Grade 3) injury will always need surgery, and like an ACL rupture, will always be a season ending, and sometimes a career ending injury.

FAARA director Stuart Imer has helped with rehabilitation or opinions on several AFL players with these uncommon injuries. Matthew Richardson and Mitch Clarke, both made excellent recoveries after surgery, while Trent Croad suffered a similar fate to Dane Swan and retired after the bittersweet 2008 Grand Final where he received a Premiership Medallion and a Lisfranc Injury.

Imer says the variation in recovery will often come down to the exact mechanism of the injury, and the severity. Excellent surgical care is a prerequisite, along with a carefully graded rehabilitation program, but much like a poor deal in a poker hand, you can only play out the cards you get. Despite all due diligence from the medical and rehabilitation teams, sometimes the end result is lacking. In some cases attempts to play on may be fruitless and can induce further degeneration leading to more surgery and the possibility of a lifetime of difficulty weight bearing, let alone playing elite collision sports.

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