What Is the Lisfranc Ligament?

The Lisfranc ligament is a ligament found in the foot and provides structural stability for the Lisfranc joint, which is the joint in the middle of the foot that allows for flexion of the arch. It connects two bones: the second metatarsal bone and the first, or medial, cuneiform bone. The Lisfranc joint, and by extension, the ligament, are named for a Joseph Lisfranc, a French field surgeon in the army of Napoleon. He observed a number of injuries to this area in soldiers who fell from horses, catching their feet in their stirrups. At that point in history, a severe injury to this portion of the foot could result in a need for amputation, a procedure which allowed Lisfranc to gain insight into this portion of human anatomy and its function.

Injuries to the Lisfranc joint usually involve damage to the Lisfranc ligament as well. Several bones make up the Lisfranc joint, but when discussing the Lisfranc ligament, the bones involved are the second metatarsal and the first of the three cuneiform bones that make up what is known as the cuneiform complex. The Lisfranc ligament connects the base of these two bones on the bottom of the foot and provides stability for this joint. The metatarsal bones are the bones in the portion of the foot between the toes and the arch. The cuneiform complex consists of three bones that form part of the structure of the arch on the inside of the foot.

In most people, the Lisfranc ligament is a single, wide band of connective tissue that connects the two bones on the plantar surface, or bottom of the foot. About 20% of people have a second band of this ligament that connects the two bones on the dorsal, or upper, surface of the joint as well. It is possible for people with this variation of the ligament structure to injure only one of the two ligaments.

Generally, two basic causes result in a majority of Lisfranc joint and ligament injuries. Direct trauma, such as can occur during a car accident or a crushing injury due to a heavy object being dropped on the foot are one possible cause. These injuries result in damage to the ligament less often than indirect trauma injuries, which are caused by extreme stress on the joint, such as when the foot is folded underneath itself during a fall. When the joint is overextended in any direction, ligament damage often occurs. A stretching of the Lisfranc ligament is known as a sprain and more severe damage, including tears and separations, are possible.