Divergent Lisfranc fracture-dislocation

Case contributed by Dr Ankit Balani

Presentation

Direct crush injury to the right foot - run over by a bus.

Patient Data

Age: 30 years
Gender: Male

Fracture-dislocation of 1st metatarsal base with medial displacement. There is also fracture-dislocation of 2nd-5th metatarsal bases with lateral displacement in keeping with divergent Lisfranc fracture-dislocation. There were associated comminuted fractures of head of 2nd metatarsal, phalanges of 2nd digit with dislocation of 2nd metatarsophalangeal joint. 

Case Discussion

Loss of alignment of 2nd metatarsal bone with intermediate cuneiform is characteristic of injury to Lisfranc ligament. It is a severe injury and debilitating if untreated.

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