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Fracture, Lisfranc, Sports Medicine

William H. West, MD and Kenneth Bielak, MD, FACSM, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Injury may occur from direct or indirect mechanisms.

  • Direct injury occurs with crush injury to the tarsometatarsal joint.

  • Causes of indirect injury:

    • Hindfoot placed in a fixed position ...

DIAGNOSIS

HISTORY

  • Determine the mechanism of injury as outlined above.

  • May present with diffuse foot pain:

    • High index of suspicion needed. Up to 20% of subtle injuries may be missed on initial exam.

  • Was t...

TREATMENT

  • Nonoperative management for those with stable injury with no diastasis 6:

    • Immobilization in short walker boot with protected weight-bearing for 2 wk and then reexamination:

      • If tenderness has r...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Early orthopedic referral is indicated for any fracture, dislocation, or instability of the Lisfranc joint. 

REFERENCES

1
Kent RW, Lievers WB, Riley PO, et al. Etiology and biomechanics of tarsometatarsal injuries in professional football players: a video analysis. Orthop J Sports Med.  2014;2(3):2325967...

ADDITIONAL READING

  • Coetzee JC. Making sense of Lisfranc injuries. Foot Ankle Clin.  2008;13(4):695–704.

  • Eleftheriou K, Rosenfeld P. Lisfranc injury in the athlete: evidence supporting management f...

CLINICAL PEARLS

  • Have high index of suspicion for Lisfranc injuries with high-energy trauma, plantar ecchymosis, or inability to bear weight.

  • Instability requires prompt referral to orthopedic surgeon f...

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