The Lisfranc joint was named after a field surgeon who described an amputation through the joint due to gangrene from an injury sustained after a soldier fell from a horse. Lisfranc injuries account for less than 1% of fractures and can result from high-energy trauma or less stressful twisting injuries. Diagnosis can be difficult as swelling and pain in the midfoot region are often the only findings. Treatment involves immobilization for mild sprains but surgery within 1-2 days for fractures or dislocations to ensure proper healing and prevent long-term disability. Surgical techniques include open reduction and internal fixation to anatomically realign the bones which allows for better functional outcomes compared to fusion or casting.

1. Lisfranc Injury An In-depth Study By: Jeff Freshour

6. Radiographic Studies Anteroposterior non­weight-bearing radiograph of the left foot. Note that this view shows no evidence of malalignment or any other joint disruption

7. Radiographic Studies Figure 1. Lateral non­weight-bearing radiograph showing dorsal displacement of the proximal base of the second metatarsal in the left foot of the patient in the illustrative case. The arrow points to the "step-off" point (i.e., the dorsal surface of the second metatarsal is higher than the dorsal surface of the middle cuneiform).

8. Radiographic Studies Figure 2. Anteroposterior weight-bearing radiograph of the left foot of the patient in the illustrative case. The medial margin of the second metatarsal base and the medial edge of the middle ( second ) cuneiform are malaligned ( triangles ). A fleck sign ( arrow ) is also present. Figure 3. Enlargement of the radiograph shown in Figure 2. Note the fleck sign ( arrow ), which is a bony fragment indicating severe disruption of the Lisfranc joint. The triangles indicate the malalignment of the proximal base of the second metatarsal and the medial margin of the middle cuneiform.

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