Typically, a Lisfranc injury occurs when there is a severe twisting force on the joints connecting the forefoot and midfoot. The forefoot is stuck in place as the force of the athlete's weight twists around the fixed forefoot during a sudden change in direction on the field or with a tackle. Another mechanism in offensive lineman results from a direct blow compression injury through their foot while blocking an opposing defender. Lisfranc injuries can tear ligaments between the forefoot and midfoot bones, fracture the bones themselves, or have a combination of both injuries.
Lisfranc injuries are usually diagnosed based on the athlete's description of the injury mechanism and the physical examination. There is typically severe pain in the midfoot region and an inability to bear weight on the foot. Swelling and bruising often occurs and may even become evident on the bottom of the foot. On a physical exam, the injured athlete will be tender over the midfoot and painful to motion passive motion at the midfoot and forefoot junction.
A Lisfranc injury is serious and can be career threatening for elite athletes if it is not recognized and appropriately treated. Failure to restore the anatomy can result in chronic foot pain and secondary arthritis of the involved joints. If there is any displacement of the bones or associated fractures in this region, surgical fixation is usually necessary to restore normal anatomy and increase the likelihood of predictable healing. Consult with your SportsMD specialist if you suspect that you have sustained an athletic Lisfranc injury, and read more about this injury and its management in our SportsMD injury knowledgebase.
Published by Kyle Naylor
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