Lisfranc Fracture Dislocation

Lisfranc fracture-dislocation is a tarsometatarsal dislocation due to hyperplantar flexion over fixed forefoot; 20% are missed.

Causes

Causes include a blow to the foot such as occurred with Lisfranc’s soldier or in certain athletic injuries.

• Mechanism involves severe plantar flexion of the foot
• May occur from sports-related injuries
• Automobile accidents
• Falling from a height, down stairs.
• Ligamentous injuries alone, even without fracture or dislocation, may result in instability on weightbearing

Signs

• Midfoot pain
• Midfoot swelling
• Difficulty ambulating

Treatment

The potential difficulties in treatment and the complications that a Lisfranc injury can lead to, early diagnosis and treatment is essential. There is no consensus on treatment when the diagnosis has been delayed. Treatments such as includes:

• Six weeks in a short-leg walking cast or splint, for non-displaced fractures
• Use of a rigid arch support
• Surgery