Lisfranc injury

[1][2] The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.

[4] Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot and are often seen in traffic collisions or industrial accidents.

[6] In athletic trauma, Lisfranc injuries occur commonly in activities such as windsurfing, kitesurfing, wakeboarding, or snowboarding (where appliance bindings pass directly over the metatarsals).

[8] The diagnosis becomes more challenging in the case of low energy incidents, such as might occur with a twisting injury on the racquetball court, or when an American Football lineman is forced back upon a foot that is already in a fully plantar flexed position.

In the majority of cases, early surgical alignment of bone fragments to their original anatomical position (open reduction) and stable fixation is indicated.

[15] When a Lisfranc injury is characterized by significant displacement of the tarsometatarsal joint(s), nonoperative treatment often leads to severe loss of function and long-term disability secondary to chronic pain and sometimes to a planovalgus deformity.

In cases with severe pain, loss of function, or progressive deformity that has failed to respond to nonoperative treatment, mid-tarsal and tarsometatarsal arthrodesis (operative fusion of the bones) may be indicated.

[17] During the Napoleonic Wars, Jacques Lisfranc de St. Martin encountered a soldier who had developed vascular compromise and secondary gangrene of the foot after a fall from a horse.

Lisfranc ligaments: [ 4 ]
C1 = Medial cuneiform
M2 = 2nd metatarsal base
M3 = 3rd metatarsal base
Red = dorsal Lisfranc ligament
Blue = interosseous Lisfranc ligament
Green = plantar Lisfranc ligament.
Lisfranc fracture (marked by the oval). This case also has fractures of the distal second (marked by the arrow), third , and fourth metatarsal bones .