Lisfranc Injury

Tarsometatarsal fracture dislocation characterized by traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal

Aetiology

  • High energy, often have other injuries

Clinical presentation

  • Severe midfoot pain
  • Inability to bear weight

Investigations

  • X-ray - AP and oblique views
    • Fracture may be subtle
    • Alignment is key - assess 1st and 2nd TMT joint congruity on the AP view, assess 3rd to 5th TMT joint congruity on the oblique view
  • CT - Lisfranc fractures usually involve several TMT joints, with multiple ligamentous avulsion fractures, which is shown best by CT

Management

  • Require fixation - ORIF

Complications

  • Can cause long term disability, OA