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A Lisfranc injury is an injury to the Lisfranc joint in your foot. This joint connects the metatarsal bones (long bones that lead up to the toes) to the tarsal bones (bones in the arch of the foot). The Lisfranc ligament, a tough band of tissue that joins these bones, helps to maintain proper alignment and strength of the Lisfranc joint.
Lisfranc injuries occur as a result of direct or indirect forces or stress on the foot. Direct forces often involve a heavy object falling on the foot, while indirect forces involve twisting or stretching the foot. While an injury such as this can occur from an action as simple as missing a step on a staircase, if you are one of the following, you may be especially at risk of sustaining a Lisfranc injury:
The key sign of a Lisfranc injury is bruising or blistering on the arch or top of the foot.
Other symptoms of a Lisfranc injury may include:
Lisfranc injuries are known for being easily misdiagnosed. They often present as ankle sprains or other foot/ankle injuries. This makes the diagnosis especially important for these injuries.
To arrive at a diagnosis, both physical examinations and imaging tests are necessary. The sports medicine physician or surgeon will ask questions about how the injury occurred and will examine the foot to determine the severity of the injury. X-rays and other imaging studies can assist in fully evaluating the extent of the injury. The physician or surgeon may also perform an additional examination while the patient is under anesthesia to further evaluate a fracture or weakening of the joint and surrounding bones.
The physical examination may include exercises like standing on the tiptoes of the injured foot or holding the toes and moving them up and down. Standing on the tiptoes puts significant stress on the midfoot, and the patient should notice pain from even a slight Lisfranc injury. Meanwhile, moving the toes up and down puts pressure on the midfoot, which will also produce pain if there in an injury there.
Imaging for a Lisfranc injury may include X-rays to show any broken bones and the alignment of the Lisfranc joint complex. If it is out of alignment, it may suggest that there is injury to the ligaments in that area of the foot. X-rays of the undamaged foot may help for comparison. In some cases, CT scans or MRIs will also be used. These tests provide more detailed imaging of the foot than X-rays and allow doctors to view soft tissues.
Nonsurgical treatments for Lisfranc injuries include the following:
Lisfranc injuries that include a bone fracture, joint dislocation or abnormal positioning, or torn ligaments may require surgery. Surgical treatments for Lisfranc injuries include the following: