Lisfranc

Lisfranc is an eponym used in medicine to refer to structures and injuries of the midfoot, as well as to the surgeon who first described them. The term is named for Jacques Lisfranc de Saint-Germain, a 19th-century French surgeon who contributed to the understanding of midfoot injuries and their management. In anatomy, the Lisfranc joint refers to the tarsometatarsal joints where the metatarsals articulate with the distal row of tarsal bones. The key stabilizing structure is the Lisfranc ligament, an interosseous band between the medial cuneiform and the base of the second metatarsal, complemented by dorsal and plantar ligaments that reinforce the midfoot.

Lisfranc injury denotes a fracture-dislocation of the tarsometatarsal joints. It may involve fractures of the bases of the metatarsals, ligamentous disruption with joint incongruity, or a combination of both. Mechanisms include axial load on a plantarflexed foot, often from falls or vehicle-related injuries, and in athletes can occur with twisting forces. The injury is frequently missed on initial examination or plain radiographs, which can delay treatment and increase the risk of long-term complications such as instability and post-traumatic arthritis.

Diagnosis commonly relies on radiographs, including weight-bearing views; CT or MRI can aid in identifying subtle displacements or associated injuries. Treatment depends on stability: stable, non-displaced injuries may be managed with immobilization and protected weight-bearing, while unstable injuries or dislocations usually require surgical intervention to restore alignment. Operative approaches often involve open reduction and internal fixation, with fusion considered in certain cases to mitigate arthritis risk. Early, accurate management improves outcomes and reduces chronic pain and deformity.