A Lisfranc Injury Is A Frequently Misdiagnosed Foot Injury
Named after a Napoleonic surgeon Jacques Lisfranc de St. Martin, a Lisfranc injury is an injury to the midfoot. It is an injury of relatively rare occurrence and often misdiagnosed, mistaken for a simple sprain with sometimes dire consequences. This tendency for misdiagnosis (somewhere around 20-40%) is especially so if the injury is as a result of a twist, misstep, or fall, which are all common ways to suffer a common lateral ankle sprain which is often what a Lisfranc sprain is confused with. A Lisfranc injury however is a significant injury to the foot, an injury that may take many months to rehabilitate and depending on the severity of injury, may sometimes require surgery to effectively allow the individual to return to their pre-injury activity levels.
What Is A Lisfranc Injury?
Also called Lisfranc fracture-dislocations a Lisfranc injury involves disruption to the Lisfranc joint. The Lisfranc joint represents the articulation between the midfoot and forefoot, injury here can present here as being fractures to bones in the midfoot, or sprains to ligaments supporting the midfoot. Specifically the Lisfranc joint is the articulation of the tarsus with the metatarsal bases. Where the first three metatarsals articulate respectively with the three cuneiforms, and the 4th and 5th metatarsals articulate with the cuboid. With special attention placed on the 2nd tarsometa-tarsal joint and Lisfranc ligament, this being the junction between the second long bone of the foot (the one directly adjacent to the big toe) and the small cube like bones closer to the ankle and their supporting ligaments. These injuries can occur in numerous circumstances, such as motor vehicle accidents, crush injuries and falls. Indirect mechanisms include axial force through the foot, or twisting on a plantar flexed foot. A Lisfranc injury encompasses everything from a mild sprain of teh supporting ligaments without instability of the Lisfranc complex, to the complete disruption of the normal anatomy through the midfoot joints, complex fracture-dislocations involving many joints and bones in the midfoot, rendering the foot clinically unstable, requiring surgical stabilisation.
The Anatomy Of The Lisfranc Joint
The midfoot as it would suggest is the middle region of the foot (in part, highlighted above). Clearly all parts of the foot are crucial, the mid foot is crucial in its role whereby the cluster of small bones and ligaments help form and stabilize the arches of the foot. These arches among other functions, provide natural shock absorption, help form a rigid platform for force transmission and propulsion walking, running and jumping, as well as move and adjust to assist in postural stabilisation. Disruption to the continuity, or stability of any part of the midfoot can have massive functional implications. The Lisfranc complex making up part of the midfoot has a specialized bony and ligamentous structure, providing stability to the foot and its arches, injury to which albeit uncommon, as mentioned numerous times can cause significant functional impairment and requires medical assessment.
Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Lisfranc Injury A Injury To The Midfoot should consult his or her physiotherapist, general practitioner, sports medicine specialist or orthopaedic surgeon.