Lisfranc Injury
The Lisfranc joint is the point at which your metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The Lisfranc ligament is a tough band of tissue that joins these two bones. This ligament is important for maintaining proper alignment and strength of the joint.
There are three types of Lisfranc injuries, which sometimes occur together:
- Sprains. The Lisfranc ligament and other ligaments on the bottom of the midfoot are stronger than those on the top of the midfoot. When they are weakened through a sprain (a stretching of the ligament), you may experience instability of the joint in the middle of the foot.
- Fractures. A break in a bone in the Lisfranc joint can be either an avulsion fracture (a small piece of bone is pulled off) or a break through the bone or bones of the midfoot.
- Dislocations. The bones of the Lisfranc joint may be forced from their normal positions.
Causes
Injuries to the Lisfranc joint most commonly occur in car accidents, military activities, contact sports, or small accident such as missing a step on a staircase. Lisfranc injuries occur as a result of direct or indirect forces to the foot. A direct force often involves something heavy falling on the foot. Indirect force commonly involves twisting the foot.
Symptoms
Symptoms of a Lisfranc injury may include:
- Swelling of the foot
- Pain throughout the midfoot when standing or when pressure is applied
- Inability to bear weight (in severe injuries)
- Bruising or blistering under the arch. Bruising may also occur on the top of the foot.
- Abnormal widening of the foot
Our Approach
Lisfranc injuries are sometimes mistaken for ankle sprains, making the diagnostic process very important. To arrive at a diagnosis, we will determine how the injury occurred and examine the foot to determine the severity of the injury. X-rays and other imaging studies may be necessary to fully evaluate the extent of your injury. We may also perform an additional examination while you are under anesthesia to further evaluate any fractures or weakening of the joint and surrounding bones.
Certain types of Lisfranc injuries may require surgery. We will determine the type of procedure that is best suited for you.