Lisfranc (Mid-foot) Injuries

Shay McLeod

The Lisfranc Joint
The Lisfranc joint is the point at which the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The bones are held in place by connective tissues (ligaments) that stretch both across and down the foot. This is important for maintaining proper alignment and strength of the joint.

Injury
Injuries to the Lisfranc joint most commonly occur as a result of direct trauma such as in automobile accidents. However can also be the result of a twisting mechanism especially with a fixed forefoot. For this reason Lisfranc injuries can often be mistaken for a simple ankle sprain but in reality these injuries tend to be worse and can take many months to recover. Lisfranc injuries result if bones in the midfoot are broken or ligaments that support the midfoot are torn. The severity of the injury can vary depending on what structures are involved. If there is just a simple sprain of the ligaments then usually the management involves a period of non-weight bearing and immobilisation but if there is a fracture or the joint is disrupted then surgical fixation is required.

Shay McLeod practices from Advance Healthcare Hoppers Crossing. He was a treating practitioner in the LEAP study, a randomised controlled trial comparing the results of ‘’wait and see, corticosteroid injection, and education and exercise’’ in the management of lateral hip pain. Results favoured education and exercise at 8 weeks and 52 weeks follow up when comparing pain and the proportion of people reporting they were at least moderately better.