Lisfranc (Midfoot) Injury

What is a Lisfranc Injury?

The tarsometatarsal joint or Lisfranc joint is the region in the middle of the foot formed by the articulation of the tarsal bones (a cluster of seven bones) and metatarsal bones (a group of five long bones). This region supports the arch of the foot. Lisfranc or midfoot fractures are breaks in the bones of the midfoot. Lisfranc injuries can involve torn ligaments that support the midfoot. The injury can be simple or complex, involving many bones and joints of the midfoot. A Lisfranc injury is sometimes mistaken for a sprain in the foot

Causes

A Lisfranc injury can occur due to the twisting of the foot, trapping of the foot on a paying surface and someone falling on it (low-energy injury), a fall from a height, or a traumatic motor accident (high-energy injury).

Symptoms

Lisfranc injuries are characterized by pain and the inability to bear weight. The appearance of bruises and swelling on the bottom of the midfoot are commonly observed symptoms.

Diagnosis

Your doctor will first examine the physical condition of the foot by inspection and palpation (feeling), then order X-rays, CT or MRI scans to provide more information about your condition.

Treatment

Non-displaced fracture (or in the absence of instability): can be treated with rest, application of ice, elevation of your foot, NSAIDs (to help with pain and inflammation) and immobilization.

Displaced fracture: the bones may be surgically aligned in their correct position and held with screws and pins, There are new techniques to replace ligaments with synthetic and biologic scaffolds are gaining popularity with excellent outcomes in young, active patients.