Lisfranc injuries, affecting the midfoot region, occur when the bones in the midfoot are fractured or the supporting ligaments are torn. Named after the French surgeon Jacques Lisfranc de St. Martin, who first described these injuries in cavalry soldiers during the Napoleonic era, this condition remains a significant medical concern.
The severity of a Lisfranc injury can range from minor damage involving a single joint to complex cases with multiple joint disruptions and fractures. While mild Lisfranc injuries might appear similar to a simple sprain—often resulting from a straightforward twist or fall—they should not be underestimated. Damage to the Lisfranc joint is more than a routine sprain and requires careful evaluation and treatment. Left untreated, even a minor Lisfranc injury can lead to long-term complications, including chronic pain and mobility issues. Recovery often spans several months, with some cases necessitating surgical intervention for proper healing.
Anatomy of the Lisfranc Joint: Structure and Function
The midfoot, located in the central region of the foot, consists of a cluster of small bones that form the arch visible on the top of the foot. From this cluster, five long bones, known as metatarsals, extend outward to connect with the toes. These bones are stabilized by robust ligaments forming the Lisfranc joint complex, which secures the bones both across and along the foot. Notably, there is no ligament connecting the first and second metatarsals, making this area vulnerable to injury during twisting falls, which can result in fractures or dislocations.
The Lisfranc joint complex plays a crucial role in foot stability and function, as it permits minimal movement while providing critical support to the arch. This stability is essential for the effective transfer of force during walking, as the midfoot channels the power generated by the calf muscles toward the front of the foot. When a Lisfranc injury is not properly treated, it can lead to persistent instability in the arch, potentially causing it to collapse or flatten, which may significantly impair walking and overall foot function
The Lisfranc joint complex includes the bones and ligaments that connect the midfoot and forefoot. Lisfranc injuries include ligament strains and tears, as well as fractures and dislocations of bone (far right).