Lisfranc Injury: A Tarsometatarsal Joint Injury

Lisfranc Injuries Vary In Severity

Tarsometatarsal joint injury also known as a Lisfranc injury, or a Lisfranc Fracture-Dislocation is an injury at the midfoot. These tarsometatarsal joint (TMT joint) injuries can vary from being a more simple injury to something considerably more complex. An example of a simple TMT joint injury would be a sprain affecting only a single joint, with more complex injuries disrupting multiple different joints, including multiple fracture sites.

Causes Of Tarsometatarsal Joint Injury

The major causes of Lisfranc injuries:

• Low-energy TMT Joint Injuries: These low-energy injuries to the TMT joint are often sports related injuries, often the result of a simple twist and/or fall when playing, or training. Occurring in football codes including soccer, or American football. This type of Lisfranc injury are often the result of falling over the top of a foot that is plantaflexed (where the toes are pointed downwards).
• High-energy TMT Joint Injuries: More severe TMT joint injuries occur as a result of motor vehicle accidents, or from direct trauma such as a fall from a height. High-energy injuries are understandably more serious and can result in multiple fractures and dislocations of the tarsometatarsal joints. Again the position of a plantaflexed foot this time on a pedal during a motor vehicle accident, or attempting to land from a fall from height and this considerable force can lead to substantially more damage to the midfoot than a low-energy TMT joint injury.
• Crush Injuries to the TMT Joint: Direct crush injury to the foot can result in tarsometatarsal joint injury. Examples of such crush injuries include a heavy weight being dropped on the foot perhaps when training at the gym, or moving heavy furniture. Another example of crush injury to the midfoot, that believe it or not I have seen a few people for over the years, is having a car drive over top of a foot.

Signs And Symptoms Relating To TMT Joint Injury

Common Signs And Symptoms Of A Tarsometatarsal Joint Injury Include:

• The individual will typically feel their pain worsens with standing, walking or pushing off on the injured foot. Generally weight bearing will be uncomfortable and pain worsens with prolonged weight bearing and higher loads.
• The top of the foot may be swollen, bruised and painful. Although not always present and frequently not significant compared to the common lateral ankle sprain which many will swell quite alarmingly, a TMT sprain may not present with substantial swelling. However, if there is swelling it will be located lower down in the mid for compared to the standard ankle sprain where the swelling is positioned higher up closer to the ankle and ankle bones.
• Bruising on bottom of the foot is highly suggestive of a TMT Joint Injury. Couple this sign with a crush injury, or plantaflex type sprain and one should strongly suspect TMT joint injury.

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 Tarsometatarsal Joint Injury should consult his or her physiotherapist, general practitioner, sports medicine specialist or orthopaedic surgeon.