Lisfranc fracture dislocation

Question 1

How does Lisfranc injuries occur ?

Answer 1

crush injury/Compression injury.
Axial loading on plantar flexed foot - landing on toes after falling from height.

Question 2

What are the Xray findings of lisfranc injury ?

Answer 2

Fleck sign - Bony fragments at the bases of the first and second metatarsal.

Widening of the joint between the bases of the first and second metatarsal.

Displacement of the bases of the metatarsals and corresponding tarsal bones.

Question 3

What should the alignment of the bases of the metatarsals and tarsal bones be on the DP view ?

Answer 3

Medial aspect of the second metatarsal should align with the medial aspect of the medial aspect of medial cuneiform.

Question 4

What should the alignment of the bases of the metatarsals and tarsal bones be on the oblique view ?

Answer 4

Medial aspect of the third metatarsal should align with the medial aspect of the lateral cuneiform.

Medial aspect of the fourth metatarsal should align with the medial aspect of cuboid.

Question 5

What is the homolateral subtype of a Lisfranc injury ?

Answer 5

Lateral displacement of 2-5 metatarsals. 1st congruent.

Question 6

What is the divergent subtype of a Lisfranc injury ?

Answer 6

lateral displacement of 2-5th metatarsals and medial displacement of the 1st metatarsal.

Question 7

What is the isolated subtype of a Lisfranc injury ?

Answer 7

Medial displacement of 1st metatarsals and the rest remain congruent.