Typical X-ray findings would include a gap between the base of the first and second toes.
Lisfranc fx skin#
Further, the nature of the injury will create heightened clinical suspicion and there may even be disruption of the overlying skin and compromise of the blood supply. There will be deformity of the midfoot and X-ray abnormalities should be obvious. In a high energy injury to the midfoot, such as a fall from a height or a motor vehicle accident, the diagnosis of a Lisfranc injury should, in theory at least, pose less of a challenge. This case also has fractures of the distal second (marked by the arrow), third, and fourth metatarsal bones. This can also be seen in pivoting athletic positions such as a baseball catcher or a ballerina spinning. American football players occasionally acquire this injury, and it most often occurs when the athlete's foot is plantar flexed and another player lands on the heel.
In athletic trauma, Lisfranc injuries occur commonly in activities such as windsurfing, kitesurfing, wakeboarding, or snowboarding (where appliance bindings pass directly over the metatarsals).
Examples of this type of trauma include a rider falling from a horse but the foot remaining trapped in the stirrup, or a person falling forward after stepping into a storm drain. Indirect Lisfranc injuries are caused by a sudden rotational force on a plantar flexed (downward pointing) forefoot. ĭirect Lisfranc injuries are usually caused by a crush injury, such as a heavy object falling onto the midfoot, or the foot being run over by a car or truck, or someone landing on the foot after a fall from a significant height. Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot and are often seen in traffic collisions or industrial accidents. Such injuries typically involve the ligaments between the medial cuneiform bone and the bases of the second and third metatarsal bones, and each of these ligaments is called Lisfranc ligament. It is these articulations that are damaged in a Lisfranc injury.
The midfoot consists of five bones that form the arches of the foot (the cuboid, navicular, and three cuneiform bones) and their articulations with the bases of the five metatarsal bones.
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