Missed Lisfranc fracture

Case contributed by Dr Chris O'Donnell

Presentation

Injury to right foot 10 weeks ago. Persistent severe pain

Patient Data

Age: 25
Gender: Female
X-ray

Gross assymetrical periarticular osteoporosis due to disuse.  Subtle fracture (arrow) on lateral border of right medial cunieform with slight widening of cuneiform-2nd metatarsal space on weight bearing

MRI

Avulsion fracture (arrow) of the Lisfranc ligament origin from the medial cuneiform.  Ligament remains in continuity.  Fluid fills the fracture site.

Case Discussion

Disruption to the ligament or avulsion fracture causes significant midfoot instability and pain hence the substantial disuse osteoporosis
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Case information

rID: 17229
Case created: 28th Mar 2012
Last edited: 25th Sep 2016
Inclusion in quiz mode: Included

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