Lisfranc injury

Case contributed by Tom Foster
Diagnosis almost certain

Presentation

Inversion injury 2 days previously. Tender 2nd to 4th metatarsals.

Patient Data

Age: 75 years
Gender: Female
x-ray

Increased distance between the medial cuneiform and 2nd metatarsal on the AP view, in keeping with a Lisfranc injury.

x-ray

Operative fixation was carried out a few days later to stabilize the midfoot.

Case Discussion

This is a case of a Lisfranc injury (or Lisfranc fracture-dislocation), an important finding to identify if present. If missed this can lead potentially to chronic pain and midfoot arthritis (with potential medicolegal implications!), so internal fixation is indicated to restore stability of the Lisfranc joint and hopefully avoid any long term complications.

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