Everything you need to know about Lisfranc injuries
The Lisfranc line is located in the foot where your metatarsal bones connect to the tarsal bones. Lisfranc injuries are complex and can range from mild to severe, with various treatment methods depending on the nature and severity of the trauma. Early diagnosis and appropriate treatment are crucial to prevent long-term complications such as chronic pain and instability. Read on to learn more about this injury and how you can avoid it.
Where in the foot does a Lisfranc injury occur? A Lisfranc injury is an injury to the tarsometatarsal joint complex of the midfoot, meaning the joints and ligaments that stabilize and connect the midfoot. This injury can range from simple trauma to the ligaments to severe fractures and dislocations. The joint complex is located between the metatarsal bones and the tarsal bones.
Causes of a Lisfranc injury
A Lisfranc injury can occur in different ways, either directly or indirectly. A direct Lisfranc injury usually occurs due to a crushing injury. Think of a vehicle accidentally driving over your foot or when you drop a heavy object on your foot. An indirect Lisfranc injury often results from rotational trauma (overstretching).
Indirect injuries are more common in sports. Lisfranc injuries frequently occur in sports like kitesurfing or snowboarding. In these sports, the athlete’s feet are secured to the board with bindings directly over the midfoot bones. This injury is also common in sports like American football or basketball, due to the frequent rotational movements made by the athletes.
Different types of Lisfranc injuries
There are different grades of Lisfranc injuries:
Ligamentous sprains: These are less severe injuries where the ligaments that hold the bones in place stretch or tear without any displacement of the bones. This type of injury is common among athletes.
Fractures: These can occur in the metatarsal bones or the tarsal bones and vary in severity.
Fracture-dislocations: These are severe injuries where there are both fractures and dislocations of the bones in the tarsometatarsal joint complex. These often occur in high-energy trauma, such as car accidents or falls from a height.
Treatment of a Lisfranc injury
Lisfranc injuries are often difficult to diagnose and are frequently missed during an initial evaluation. Correct and early recognition of this injury is crucial because an untreated Lisfranc injury can lead to long-term pain, instability, and eventually even arthritis.
Treatment of a Lisfranc injury varies depending on the severity of the injury. When there is no dislocation (displacement) at the time of injury, the injury can be treated with non-operative methods, such as immobilization with a cast or brace. A 2007 study suggests that when the displacement in athletes is less than 2 millimeters, a fracture can also be treated with just a cast. However, Lisfranc injuries often require surgical intervention to anatomically reposition and secure the bones with screws or plates to promote optimal healing. Research from 2010 even suggests that limited arthrodesis (the surgical fusion of certain joints) can be beneficial for complex fractures and injuries for better outcomes.
If you are experiencing pain in the midfoot or suspect you have sustained a Lisfranc injury, don’t hesitate to consult a specialist. Our podiatrists are ready to help you with the correct diagnosis and provide the best care so you can move pain-free again.
Schedule an appointment by clicking here and have your feet checked from heel to toe.
Want to learn more about this? Consult the following researches:
Lattermann C, Goldstein JL, Wukich DK, Lee S, Bach BR Jr (July 2007). “Practical management of Lisfranc injury in athletes”. Clin J Sport Med. 17 (4): 311–51. doi:10.1097/JSM.0b013e31811ed0ba
Stavlas, P., Roberts, C. S., Xypnitos, F. N., & Giannoudis, P. V. (2010, July). The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature. International Orthopaedics, (34), 1083–1091. SICOT. DOI 10.1007/s00264-010-1101-x