A painful foot: Lisfranc fracture-dislocationsBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i882 (Published 07 March 2016) Cite this as: BMJ 2016;352:i882
- Matthew Welck, consultant orthopaedic surgeon1,
- Ruslan Zinchenko, foundation year 2 doctor2,
- Francois Tudor, consultant orthopaedic surgeon3
- 1West Herts NHS Trust, Watford WD18 0HB, UK
- 2St George’s Hospital, London, UK
- 3Gold Coast University Hospital, Southport, Qld, Australia
- Correspondence to: M Welck
A fit and well 25 year old man presented to the emergency department with a painful left foot after being tackled while playing football. His left foot had been in plantar flexion when he was tackled just as he was about to kick the ball.
He could not continue playing but could bear weight straight away. His teammates brought him to the emergency department after the match because of increasing pain. A detailed clinical examination showed marked swelling over the dorsum of the left foot, tenderness in the dorsomedial midfoot, and plantar ecchymosis. Weight bearing anteroposterior, internal oblique (figs 1 and 2⇓), and lateral radiographs of the left foot showed a Lisfranc fracture-dislocation of the second tarsometatarsal joint.
What is the anatomy of the Lisfranc joint?
How do acute and chronic Lisfranc injuries usually present?
How do you investigate Lisfranc injuries?
How do you manage Lisfranc injuries?
1. What is the anatomy of the Lisfranc joint?
The Lisfranc (tarsometatarsal) joints are formed by the five metatarsal bones distally and the cuboid bone and three cuneiform bones proximally. The Lisfranc ligament attaches the medial cuneiform bone to the base of the second metatarsal.
The Lisfranc joint is considered to be S shaped and is made up of three columns. The medial cuneiform bone and the first metatarsal make up the medial column. …
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