What Is a Lisfranc Fracture?

A Lisfranc fracture is a fracture or dislocation that occurs at the foot’s middle section, specifically to a group of five long bones collectively referred to as the metatarsus. Also called metatarsal bones, these structures provide bridging stability between the toes at the front and the skeletal middle and rear part of the foot known as the tarsus. The metatarsal bones, except the first and second metatarsal, are bound together by connective tissue. Dropping something on the foot or twisting it by stepping into a hole are two of the most common ways of causing Lisfranc fractures. It is a common foot injury among soccer and American football players.

The Lisfranc fracture was named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who once worked in the army under the command of Napoleon. The labeling was linked to his description of an injury soldiers experienced when they fell from their horses, twisting their trapped feet in the stirrups. In fact, Lisfranc was noted for his extensive work on fracture operations. The Lisfranc joint, a collection of articulations between the forefoot and midfoot also known as the tarsometatarsal joint, is also named after him.

The Lisfranc foot injury is split into three classifications. Homolateral injury concerns the displacement of all five metatarsal bones, or suggests a cube-like fracture. The isolated kind involves only one or two metatarsals being displaced from the other three long bones. With divergent injury, the bones are displaced in a left-and-right or front-and-back manner. The divergent kind of Lisfranc fracture may also suggest a defect in the midfoot-located navicular bone, named for its boat-like shape.

People with a Lisfranc fracture usually experience swelling or bruising at the foot. Some injuries are so severe that the patient is unable to place anything on the affected foot. Lisfranc fractures can easily be mistaken for sprains. Persistent ones that remain even after being treated with ice packs and rest may confirm the injury.

The Lisfranc fracture is very difficult to diagnose using x-rays. Orthopedists, however, can determine its presence if the patient’s sprain produces severe pain when moving the foot in a circular motion. Computed tomography (CT) scans and some type of magnetic resonance imaging (MRI) technique are used to confirm a Lisfranc fracture.

People with less serious injuries are given a cast to wear for six to eight weeks, at the end of which the orthopedist replaces it with a fixed arch support. In more extreme cases, the patient would need surgery, with pins, wires or screws used to stabilize and hold the metatarsals together for optimal healing. In all cases, patients are prohibited from putting weight on the treated foot for a certain period of time, and foot exercises are implemented to rehabilitate it to full health. Lack of diagnosis or treatment could have dire consequences such as joint degeneration and damage of nerve cell and blood vessels.