Presentation
Pain and difficulty ambulating with the left foot following a reported twisted ankle after running in an obstacle course.
Patient Data
Comminuted oblique fracture through the base of the second metatarsal with lateral displacement of the distal fracture fragment. Soft tissue swelling is noted along the midfoot. Fracture-dislocation of 2nd and 3rd metatarsal bases and subluxation of 4th and 5th metatarsal bases.
Case Discussion
This case demonstrates classic features of a Lisfranc fracture-dislocation of the foot. Findings were confirmed during surgery.
Lisfranc fractures are fractures involving the tarsometatarsal joint complex of the foot. They are relatively rare injuries that compose approximately 0.2% of all fractures. The injury mechanism often includes an indirect force such as a twisting force on the ankle as seen in this patient. Classically, this injury involves fractures and/or associated dislocation of the metatarsals. Treatment includes open reduction and internal fixation of the midfoot.
Case courtesy of Dr. Daniel Rodgers and Dr. Jane Maloof
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