Why is it called a Lisfranc injury?
The original injury described by Lisfranc usually occurred when a soldier fell from his horse, but his foot did not release from the stirrup--or so the story goes... The present day most common mechanism of this injury is when someone steps into a small hole, and the foot is unusually twisted with a great amount of force pushing down as well. However, there are many other means to sustain this type of injury including sports, falls, and automobile accidents.
What is the Lisfranc joint?
The foot can be thought to consist of three primary parts. The forefoot area consisting of the toes; the midfoot made up of the small bones called the navicular, cuneiform, and cuboid; and the hindfoot consisting of the talus (lower ankle) and calcaneus (heel). The Lisfranc joint is the space between the bones of the forefoot and midfoot.
The Lisfranc injury is an injury to the ligaments that connects these joints. Sometimes the injury is a simple dislocation (ligament injury) or a fracture and dislocation. The dislocation is a separation of the normal joints between the forefoot and midfoot. The fracture usually occurs in the midfoot bones.
How is a Lisfranc injury diagnosed?
Often this injury can be quite subtle on x-ray appearance. In order to better clarify the injury, sometimes it is necessary to apply a force to the foot in order to emphasize the dislocation. Also common is to perform an x-ray view of the normal foot as well as the abnormal foot in order to better define the injury.
What is the treatment of a Lisfranc injury?
Most often the treatment of a Lisfranc injury is surgical, although some minor injuries can be treated conservatively. If there is minimal displacement of the bones, a stiff walking cast applied for approximately eight weeks is an appropriate alternative. However, the more common treatment is to secure the fractured and dislocated bones with either internal (screws) or external (pins) fixation.
Healing is complicated in patients who sustain a Lisfranc injury. The most common complication of the Lisfranc injury is post-traumatic arthritis of the joint. Post-traumatic arthritis mimics degenerative arthritis, but its course is accelerated because of severe injury to a joint. This can lead to chronic pain in the injured joint, and may necessitate fusion of the joint in order to prevent chronic debilitating pain.
Another complication is called a compartment syndrome. The compartment syndrome occurs when traumatic injury causes swelling and bleeding to raise the pressure within the tissues of your body. If the pressure is raised sufficiently within a restricted area, the vascular supply to that area may become compromised, and this can lead to serious complications.
Last Updated: 12/6/2005