7/18/2023 0 Comments Lisfranc fx![]() ![]() ![]() Direct injuries are due to a force applied to the dorsum of the foot. Lisfranc injuries can arise from a variety of situations and mechanisms, with both direct and indirect injuries possible. Injuries are described as divergent the first metatarsal is displaced medially with any combination of the remaining four etatarsals displaced laterally. Refers to injuries where a partial segment of the joint is displaced. Injuries involve an incongruity of the entire joint. The Lisfranc ligament (red) is the most clinically significant ligament 9,10įigure 2. The joint is often separated into three columns: medial, middle and lateral columns. It divides the injuries into types A, B and C (Figure 2). 5–7,9 The Hardcastle Classification System is commonly used. ![]() Several interlinked classification systems exist for Lisfranc injuries however, they are all based on a three-column conceptualisation of the mid-foot as shown in Figure 1. 9,10 Importantly, given the arrangement of these ligaments, the dorsal aspect of the joint is significantly weaker than the plantar aspect. 8 The strongest and most clinically significant ligament is the interosseous Lisfranc ligament, which transverses from the base of the second metatarsal to the plantar surface of the medial cuneiform (Figure 1). 3 The ligaments supporting this joint can be broadly classified into dorsal, plantar and interosseous ligaments. 7 It represents the junction between the forefoot and mid-foot, and is composed of the tarsometatarsal articulations and associated ligaments. The Lisfranc joint complex was named after a 19th century French army field surgeon who first described amputation through this location. Clinically, the term is sometimes used to specifically describe an injury involving the second tarsometatarsal joint. 3,4 The technical definition of a Lisfranc injury involves the displacement of one or more of the metatarsals from the tarsus, and injuries can range from subtle subluxations to obvious fracture dislocations. 2 Awareness and a high degree of clinical suspicion is vital for this diagnosis, as it has been estimated that 20–40% of Lisfranc injuries are initially missed. 1 However, it is considered a red flag condition in general practice because of the debilitating consequences of a missed diagnosis. Injury to the tarsometatarsal joint, commonly referred as the Lisfranc joint, is a relatively rare occurrence. ![]()
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