Lisfranc Joint Injury

LISFRANC JOINT INJURY

Injury of the Lisfranc joint, also known as the Tarso-metatarsal joint, is a cause of foot pain that may be difficult to diagnose.

The Tarso-Metatarsal joint is referred to as the Lisfranc joint after Jaques Lisfranc, who was one of Napoleon’s field surgeons. He first described an amputation through this joint for the treatment of gangrene. This joint, in an average size adult foot is located about three inches down the foot from the front of the ankle.

This foot injury is relatively rare occurring in approximately one in fifty five thousand people. Injury occurs when there is high energy trauma to the top of the foot. This trauma may occur as result of a pedal injury in road traffic accidents or during contact sports such as football and rugby. When symptoms arise following direct trauma to the top of the foot it is difficult to differentiate from a Tarsal bone fracture or bone bruising. There may or may not be a swollen foot.

Treatment is dependent on the severity of the injury. If there is a sprain of the Tarso Metatarsal ligament, with no widening of the Metatarsals evident on (weight bearing) x-ray, then conservative management such as R.I.C.E and ultrasound and interferential therapy combined proprioception work should be enough especially when combined with a supportive foot orthotic such as the Orthosport Active-8 Orthotic.

Where there is more severe Tarso-Metatarsal ligament damage, the outlook is not so good. Damage to the ligament often causes instability at the Lisfranc joint complex, which is evident on x-ray as widening between the Tarso-Metatarsal joints. Many Podiatric and Orthopaedic Consultants advocate surgical fixation to reduce the likelihood of developing arthritis of the foot.

Common Lisfranc Joint Injury signs & symptoms:

  • A history of trauma to the top of the foot.
  • Foot pain on separating the Metatarsals.
  • Foot pain when walking, running and turning.