Journal List > J Korean Foot Ankle Soc > v.20(3) > 1043384

J Korean Foot Ankle Soc. 2016 Sep;20(3):106-111. Korean.
Published online September 06, 2016.  https://doi.org/10.14193/jkfas.2016.20.3.106
Copyright © 2016 The Korean Foot and Ankle Society. All rights reserved.
Lisfranc Joint Injury
Myoung Jin Lee,
Department of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, Korea.

Corresponding Author: Myoung Jin Lee. Department of Orthopaedic Surgery, College of Medicine, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Korea. Tel: 82-51-240-5167, Fax: 82-51-254-6757, Email: tynitus@dau.ac.kr
Received July 19, 2016; Revised August 23, 2016; Accepted August 24, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

The Lisfranc joint complex is an anatomical association of many bones and articulation, restrained by an even more complex network of ligaments, capsules, and fascia, which must work in concert to provide normal and painless motion. Careful diagnostic workup with high-quality radiographs and computed tomography of the foot are used to diagnose injuries and fractures of this complex. We have to understand the normal anatomy and injury mechanism in order to appropriately treat Lisfranc injuries. Good results have been associated with anatomic reductions of all bones, which was achieved with restoration of proper alignment.

Keywords: Lisfranc injury; Lisfranc joint

Figures


Figure 1
Direct mechanisms of Lisfranc injuries. Application of a direct force (A) dorsally to the base of the metatarsals can elicit plantar disruption of the Lisfranc joint (B). Application of the dorsal force (C) slightly more proximally can create a dorsal dislocation (D).
Click for larger imageDownload as PowerPoint slide


Figure 2
The second intermetatarsal space (solid line) aligns itself precisely with the corresponding intertarsal space between the middle and lateral cuneiforms. The third intermetatarsal space (dotted line) is continuous with the corresponding intertarsal space between the lateral cuneiform and cuboid, and the lateral border of the third metatarsal aligns itself to the lateral edge of the lateral cuneiform.
Click for larger imageDownload as PowerPoint slide


Figure 3
First, second, third tarsometatarsal joints were fixed with screws and fourth, fifth tarsometatarsal joints were fixes with Kirschner wires.
Click for larger imageDownload as PowerPoint slide

Notes

Financial support:None.

Conflict of interest:None.

References
1. Lisfranc J. In: Nouvelle méthode opératoire pour l'amputation partielle du pied dans son articulation tarso-métatarsienne. Paris: Gabon; 1815.
2. Aitken AP, Poulson D. Dislocations of the tarsometatarsal joint. J Bone Joint Surg Am 1963;45:246–260.
3. English TA. Dislocations of the metatarsal bone and adjacent toe. J Bone Joint Surg Br 1964;46:700–704.
4. Hardcastle PH, Reschauer R, Kutscha-Lissberg E, Schoffmann W. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone Joint Surg Br 1982;64:349–356.
5. Quénu E, Küss G. Étude sur les luxations du métatarse. Rev Chir Paris 1909;39
6. Wilson DW. Injuries of the tarso-metatarsal joints. Etiology, classification and results of treatment. J Bone Joint Surg Br 1972;54:677–686.
7. Wilppula E. Tarsometatarsal fracture-dislocation. Late results in 26 patients. Acta Orthop Scand 1973;44:335–345.
8. Brunet JA, Wiley JJ. The late results of tarsometatarsal joint injuries. J Bone Joint Surg Br 1987;69:437–440.
9. Ouzounian TJ, Shereff MJ. In vitro determination of midfoot motion. Foot Ankle 1989;10:140–146.
10. Lenczner EM, Waddell JP, Graham JD. Tarsal-metatarsal (Lisfranc) dislocation. J Trauma 1974;14:1012–1020.
11. Cain PR, Seligson D. Lisfranc's fracture-dislocation with intercuneiform dislocation: presentation of two cases and a plan for treatment. Foot Ankle 1981;2:156–160.
12. de Palma L, Santucci A, Sabetta SP, Rapali S. Anatomy of the Lisfranc joint complex. Foot Ankle Int 1997;18:356–364.
13. Myerson MS, Fisher RT, Burgess AR, Kenzora JE. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 1986;6:225–242.
14. Chiarugi G, Bucciante L. In: Istitiuaionin di Anatomia dell'uomo. 10th ed. Milan: Vallardi; 1971.
15. Yamamoto H, Furuya K, Muneta T, Ishibashi T. Neglected Lisfranc's joint dislocation. J Orthop Trauma 1992;6:129–131.
16. Rabin SI. Lisfranc dislocation and associated metatarsophalangeal joint dislocations. A case report and literature review. Am J Orthop (Belle Mead NJ) 1996;25:305–309.
17. Myerson M. The diagnosis and treatment of injuries to the Lisfranc joint complex. Orthop Clin North Am 1989;20:655–664.
18. O'Malley MJ, Hamilton WG, Munyak J, DeFranco MJ. Stress fractures at the base of the second metatarsal in ballet dancers. Foot Ankle Int 1996;17:89–94.
19. Berg JH, Silveri CP, Harris M. Variant of the Lisfranc fracturedislocation: a case report and review of the literature. J Orthop Trauma 1998;12:366–369.
20. Norfray JF, Geline RA, Steinberg RI, Galinski AW, Gilula LA. Subtleties of Lisfranc fracture-dislocations. AJR Am J Roentgenol 1981;137:1151–1156.
21. Arntz CT, Veith RG, Hansen ST Jr. Fractures and fracturedislocations of the tarsometatarsal joint. J Bone Joint Surg Am 1988;70:173–181.
22. Faciszewski T, Burks RT, Manaster BJ. Subtle injuries of the Lisfranc joint. J Bone Joint Surg Am 1990;72:1519–1522.
23. Goossens M, De Stoop N. Lisfranc's fracture-dislocations: etiology, radiology, and results of treatment. A review of 20 cases. Clin Orthop Relat Res. 1983;(176):154–162.
24. Anderson LD. Injuries of the forefoot. Clin Orthop Relat Res 1977;(122):18–27.
25. Granberry WM, Lipscomb PR. Dislocation of the tarsometatarsal joints. Surg Gynecol Obstet 1962;114:467–469.
26. Markowitz HD, Chase M, Whitelaw GP. Isolated injury of the second tarsometatarsal joint. A case report. Clin Orthop Relat Res. 1989;(248):210–212.
27. Stark WA. Occult fracture-subluxation of the midtarsal joint. Clin Orthop Relat Res 1973;(93):291–292.
28. Turco VJ, Spinella AJ. Tarsometatarsal dislocation-Lisfranc injury. Foot Ankle 1982;2:362.
29. Vuori JP, Aro HT. Lisfranc joint injuries: trauma mechanisms and associated injuries. J Trauma 1993;35:40–45.
30. Cassebaum WH. Lisfranc fracture-dislocations. Clin Orthop Relat Res 1963;30:116–129.
31. Ross G, Cronin R, Hauzenblas J, Juliano P. Plantar ecchymosis sign: a clinical aid to diagnosis of occult Lisfranc tarsometatarsal injuries. J Orthop Trauma 1996;10:119–122.
32. Heckman JD. Fractures and dislocations of the foot. In: Rockwood CA, Green DP, Bucholz RW, Heckman JD, editors. Rockwood and Green's: fractures in adults. 4th ed. Philadelphia: Lippincott-Raven; 1996. pp. 2287.
33. Arntz CT, Hansen ST Jr. Dislocations and fracture dislocations of the tarsometatarsal joints. Orthop Clin North Am 1987;18:105–114.
34. Jeffreys TE. Lisfranc’s fracture-dislocation: a clinical and experimental study of tarso-metatarsal dislocations and fracturedislocations. J Bone Joint Surg Br 1963;45:546–551.
35. Pérez Blanco R, Rodríguez Merchán C, Canosa Sevillano R, Munuera Martínez L. Tarsometatarsal fractures and dislocations. J Orthop Trauma 1988;2:188–194.
36. Resch S, Stenström A. The treatment of tarsometatarsal injuries. Foot Ankle 1990;11:117–123.
37. Lu J, Ebraheim NA, Skie M, Porshinsky B, Yeasting RA. Radiographic and computed tomographic evaluation of Lisfranc dislocation: a cadaver study. Foot Ankle Int 1997;18:351–355.
38. Ebraheim NA, Yang H, Lu J, Biyani A. Computer evaluation of second tarsometatarsal joint dislocation. Foot Ankle Int 1996;17:685–689.
39. Hansen STJ. Fractures of the foot. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, editors. Skeletal trauma. 2nd ed. Philadelphia: W.B. Saunders; 1998. pp. 2405.
40. Mittlmeier T, Krowiorsch R, Brosinger S, Hudde M. Gait function after fracture-dislocation of the midtarsal and/or tarsometatarsal joints. Clin Biomech (Bristol, Avon) 1997;12:S16–S17.