Lisfranc injury is a medical condition in which there is trauma or injury to the foot resulting in displacement of either one or all of metatarsal bones from tarsus. It is also called as Lisfranc fracture or Lisfranc dislocation. The Lisfranc ligament attaches the medial cuneiform bone to the base of the 2nd metatarsal. In Lisfranc injury there may be ligament damage or a fracture of either of the bones.
About Lisfranc Injury or Lisfranc Fracture (Dislocation)
Lisfranc joint is also known as the tarsometatarsal joints. The tarsal or the long bones present in the foot join with the metatarsals or the smaller bones to form the Lisfranc joint. Lisfranc Injury or Lisfranc Fracture (Dislocation) occurs rarely as a sports injury, but if it is ignored it can become very fatal. If a patient presents with a midfoot sprain then Lisfranc injury should be ruled out first.
Symptoms of Lisfranc Injury or Lisfranc Fracture (Dislocation)
- Pain in the midfoot region.
- Difficulty in weight bearing on the injured foot.
- The bone may be crooked or deformed.
- Swelling is present on the superior surface of the foot.
- Joint tenderness is present.
- Raising the foot and calf after weight bearing results in pain.
Causes of Lisfranc Injury or Lisfranc Fracture (Dislocation)
- Excessive force or trauma to the midfoot.
- Forceful and twisting movement to the foot e.g. stepping in a pothole.
- Certain sports where the feet are trapped in bindings such as kite surfing or snowboarding etc.
- Car accidents.
- Crush injuries.
Treatment of Lisfranc Injury or Lisfranc Fracture (Dislocation)
- Patient should seek a consultation with a medical professional promptly.
- X-ray in a weight bearing position confirms the diagnosis.
- MRI or bone scan helps in confirming the diagnosis definitely as sometimes this injury may not be visible on x-ray.
- The joint should be immobilized with a plaster cast placed below the knee having a toe plate spreading beneath the toes.
- For severe Lisfranc injury, surgery is required where the bones are fixed together using pins or wires.
- Weight bearing should be avoided for at least 6 weeks.
- Rehabilitation exercises should be started after healing in order to restore normal range of motion, strength and flexibility of the leg and foot.