Lisfranc Injuries
Treatment and Information
WHAT ARE LISFRANC INJURIES?
Lisfranc Injuries are fractures, dislocations, and sprains of the Lisfranc joint. The foot is separated into three functional sections: the hindfoot, which absorbs shock during ambulation; the midfoot, which aids in force translation and rotational stability; and the forefoot, which aids in the “toe-off” phase of gait. By allowing force to be transferred between the midfoot and the forefoot, the Lisfranc joint aids in energy dissipation.
The Lisfranc joint provides a stable axis for rotation due to its limited mobility, and it is also the keystone for plantar flexion and dorsiflexion. Plantar flexion and dorsiflexion occur along a horizontal axis that runs through the junction of the metaphysis and diaphysis at the base of the second metatarsal. Because the second metatarsal is immobile and lacks dorsal support, placing the foot in excessive plantar flexion with an axial load might produce dorsal displacement of the second metatarsal base.
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LISFRANC INJURIES: DIAGNOSIS AND CARE
Lisfranc joint injuries are uncommon, difficult to diagnose, and frequently misdiagnosed. Pain, swelling, and the inability to bear weight are common signs and symptoms. These injuries range in severity from minor sprains to fracture-dislocations. Swelling is generally detected in the midfoot area on physical examination.
Direct or indirect trauma can result in a Lisfranc joint complex injury. When an external force strikes the foot, it is known as direct trauma. Indirect trauma occurs when force is communicated to the stationary foot, causing the body’s weight to deform due to torque, rotation, or compression.
High-energy forces in motor vehicle crashes, industrial accidents, and falls from great heights can induce Lisfranc joint fractures, dislocations, and sprains. These injuries can also occur as a result of a less stressful process, such as a twisting fall. Because Lisfranc joint fracture–dislocations and sprains are associated with a high risk of persistent secondary impairment, clinicians should keep an eye out for these injuries in patients who have edema, tarsometatarsal joint discomfort, and the inability to bear weight.
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