Introduction: Lisfranc joint is the articulation between midfoot and forefoot which is composed of the five tarsometatarsal joints, named after Jacques Lisfranc de Saint-Martin who was a field surgeon in Napoleon’s army.
Epidemiology and background: Lisfranc injuries constitute approximately 0.2% of all fractures. Although rare, they can be missed by the treating orthopedic surgeon, since present literature knowledge reveals that 20% of these injuries are missed or diagnosed late. As the consequences of missing such injuries are debilitating for the patients who end up with serious disability.
Diagnosis: To make accurate diagnosis, strong background knowledge of the anatomy of the Lisfranc joint is mandatory. Plain and stress radiographs, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are augments to proper history taking and clinical examination and help in diagnosis especially in subtle unstable injuries.
Treatment: Stable injuries are treated nonoperatively. Unstable injuries are treated surgically; here, anatomical reduction and stable fixation is the standard of care. If closed reduction is unsatisfactory, open reduction should be performed. There are many modalities of fixation available, however, final outcome depends on early diagnosis, achieving anatomic reduction and maintaining it, irrespective of the method of reduction or the mode of fixation.
Complications: The common complications include osteoarthritis, persistent pain and gait abnormalities, implant-related problems, and skin problems.
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