Lisfranc (Midfoot) Injury
What Is a Lisfranc Injury?
The Lisfranc joint, also called the tarsometatarsal joint, is located in the middle of the foot where the metatarsal bones connect to the tarsal bones. This joint complex plays a critical role in maintaining the arch of the foot and providing stability during walking and running.
A Lisfranc injury involves damage to this midfoot region and may include fractures of the bones, tears of the supporting ligaments, or both. These injuries range from mild to severe and can affect multiple bones and joints within the midfoot. Because symptoms may resemble those of a simple sprain, Lisfranc injuries are sometimes overlooked or misdiagnosed, particularly after a twisting injury or fall.
Causes
Lisfranc injuries can occur from both low- and high-energy mechanisms, including:
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Twisting of the foot, often during a fall or sports-related activity
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Falls from a height
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Motor vehicle or other high-impact accidents
Symptoms
Common symptoms of a Lisfranc injury include:
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Pain in the midfoot, especially with standing or walking
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Difficulty or inability to bear weight
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Swelling and bruising, particularly on the bottom (plantar surface) of the midfoot
Diagnosis
Your doctor will begin with a careful physical examination of the foot, looking for areas of tenderness, swelling, and instability. Imaging studies are essential for confirming the diagnosis and assessing the severity of the injury. These may include X-rays, CT scans, or MRI, which help evaluate bone alignment, fractures, and ligament damage.
Treatment
Treatment depends on the severity and stability of the injury.
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Mild or stable injuries may be treated with rest, ice, elevation, anti-inflammatory medications, and immobilization in a boot or cast for several weeks.
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More severe or unstable injuries often require surgery to realign and stabilize the bones of the midfoot. This is typically done using screws or pins. In some cases, especially when joint damage is significant, a tarsometatarsal joint fusion may be recommended to restore stability and reduce long-term pain.
