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Lisfranc Injuries

The Lisfranc joint complex in the foot follows the line made between the five metatarsal bases and the tarsal bones that attach to them. A lisfranc injury refers to a fracture, sprain, or rupture of any of the bones or ligaments that make up the joint. The Lisfranc joint specifically relates to the joint between the first cuneiform and second metatarsal base.

An injury to this joint often comes about after an injury where the foot is pointed down, and pressure is placed upon the top of the foot, such as when stepping in a hole. The Lisfranc joint is named after a surgeon in Napoleon’s army, who first described the joint. It was noted that he would perform amputations to soldiers that had injured the joint after falling off a horse with their foot still caught in the stirrup.

A Lisfranc ligament injury can often go undiagnosed as they will often occur in conjunction with multiple other injuries, such as in the case of a motor vehicle accident. Typical symptoms include swelling, pain, or bruising at the top of the foot over the area of the lisfranc ligament. There may also be pain when placing weight upon the foot, or pain with movement at the middle of the foot. X-ray or ultrasound may be used to identify whether there is a rupture of the lisfranc ligament, whilst x-ray may assist in identifying a possible fracture.

Management of a Lisfranc injury will depend on the severity of the injury. Early detection is always best. Mild sprains may be managed through conservative treatment, appropriate footwear, and possible orthotics. Whilst more severe injury will require immobilisation in a moon boot or cast.