Download PDF
Semin Musculoskelet Radiol 2016; 20(02): 139-153
DOI: 10.1055/s-0036-1581119
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lisfranc Injury Imaging and Surgical Management

Eva Llopis
1   Department of Radiology, Hospital de la Ribera, Alzira, Valencia, Spain
,
Javier Carrascoso
2   Department of Radiology, Hospital Quiron, Madrid, Spain
,
Inigo Iriarte
3   Department of Rehabilitation, Clinica Ars, Bilbao, Spain
,
Mariano de Prado Serrano
4   Department of Orthopedics, Hospital Quiron Murcia, Murcia, Spain
,
Luis Cerezal
5   Department of Radiology, Centro Diagnostico Médico Cantabria, Santander, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 June 2016 (online)

Also available at
   Permissions and Reprints

Abstract

The Lisfranc joint is composed of the cuneiform bones and the cuboid and metatarsal bases, united by a synovial capsule and ligamentous complex. Familiarity with the anatomy is essential for image planning and for understanding injury patterns. The more important structures are the Lisfranc ligament and the plantar ligaments that can be visualized with MR, although careful attention to technique and orientation of scan planes is required for accuracy. A combination of conventional radiographs, computed tomography, and MR allow precise diagnosis of Lisfranc fractures, fracture dislocation, and subtle Lisfranc injuries to guide clinical management and surgical planning.

Keywords

Lisfranc - midfoot - fracture dislocation
 

  • References

  • 1 Hatem SF. Imaging of Lisfranc injury and midfoot sprain. Radiol Clin North Am 2008; 46 (6) 1045-1060 , vi
    CrossrefPubMedGoogle Scholar
  • 2 Makwana NK. Tarsometatarsal injuries—Lisfranc injuries. Curr Orthop 2005; 19 (2) 108-118
    CrossrefPubMedGoogle Scholar
  • 3 Rosenbaum A, Dellenbaugh S, Dipreta J, Uhl R. Subtle injuries to the Lisfranc joint. Orthopedics 2011; 34 (11) 882-887
    CrossrefPubMedGoogle Scholar
  • 4 Gupta RT, Wadhwa RP, Learch TJ, Herwick SM. Lisfranc injury: imaging findings for this important but often-missed diagnosis. Curr Probl Diagn Radiol 2008; 37 (3) 115-126
    CrossrefPubMedGoogle Scholar
  • 5 Calder JD, Whitehouse SL, Saxby TS. Results of isolated Lisfranc injuries and the effect of compensation claims. J Bone Joint Surg Br 2004; 86 (4) 527-530
    PubMedGoogle Scholar
  • 6 de Palma L, Santucci A, Sabetta SP, Rapali S. Anatomy of the Lisfranc joint complex. Foot Ankle Int 1997; 18 (6) 356-364
    CrossrefPubMedGoogle Scholar
  • 7 Panchbhavi VK, Molina IV D, Villarreal J, Curry MC, Andersen CR. Three-dimensional, digital, and gross anatomy of the Lisfranc ligament. Foot Ankle Int 2013; 34 (6) 876-880
    CrossrefPubMedGoogle Scholar
  • 8 Siddiqui NA, Galizia MS, Almusa E, Omar IM. Evaluation of the tarsometatarsal joint using conventional radiography, CT, and MR imaging. Radiographics 2014; 34 (2) 514-531
    CrossrefPubMedGoogle Scholar
  • 9 Umans HR. Imaging sports medicine injuries of the foot and toes. Clin Sports Med 2006; 25 (4) 763-780
    CrossrefPubMedGoogle Scholar
  • 10 Castro M, Melão L, Canella C , et al. Lisfranc joint ligamentous complex: MRI with anatomic correlation in cadavers. AJR Am J Roentgenol 2010; 195 (6) W447-W455
    CrossrefPubMedGoogle Scholar
  • 11 Kitsukawa K, Hirano T, Niki H, Tachizawa N, Nakajima Y, Hirata K. MR imaging evaluation of the Lisfranc ligament in cadaveric feet and patients with acute to chronic Lisfranc injury. Foot Ankle Int 2015; 36 (12) 1483-1492
    CrossrefPubMedGoogle Scholar
  • 12 Rao S, Nawoczensko D, Baumhauer J. Midfoot arthritis: nonoperative options and decision making for fusion. Tech Foot Ankle Surg 2008; 7 (3) 188-195
    CrossrefPubMedGoogle Scholar
  • 13 MacMahon A, Kim P, Levine DS , et al. Return to sports and physical activities after primary partial arthrodesis for Lisfranc injuries in young patients. Foot Ankle Int 2015; November 23 (Epub ahead of print)
    PubMedGoogle Scholar
  • 14 Early JS, Bucholz RW. Lisfranc injuries and their management. Curr Orthop 1996; 10 (3) 169-173
    CrossrefPubMedGoogle Scholar
  • 15 Quénu E, Küss G. Etude sur les luxations du metatarse. Reb Chir 1909; 39: 281
    PubMedGoogle Scholar
  • 16 Myerson MS, Fisher RT, Burgess AR, Kenzora JE. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 1986; 6 (5) 225-242
    CrossrefPubMedGoogle Scholar
  • 17 Curtis MJ, Myerson M, Szura B. Tarsometatarsal joint injuries in the athlete. Am J Sports Med 1993; 21 (4) 497-502
    CrossrefPubMedGoogle Scholar
  • 18 Nunley JA, Vertullo CJ. Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete. Am J Sports Med 2002; 30 (6) 871-878
    PubMedGoogle Scholar
  • 19 Ross G, Cronin R, Hauzenblas J, Juliano P. Plantar ecchymosis sign: a clinical aid to diagnosis of occult Lisfranc tarsometatarsal injuries. J Orthop Trauma 1996; 10 (2) 119-122
    CrossrefPubMedGoogle Scholar
  • 20 Verhoeven N, Vandeputte G. Midfoot arthritis: diagnosis and treatment. Foot Ankle Surg 2012; 18 (4) 255-262
    CrossrefPubMedGoogle Scholar
  • 21 Faciszewski T, Burks RT, Manaster BJ. Subtle injuries of the Lisfranc joint. J Bone Joint Surg Am 1990; 72 (10) 1519-1522
    Google Scholar
  • 22 Davies MS, Saxby TS. Intercuneiform instability and the “gap” sign. Foot Ankle Int 1999; 20 (9) 606-609
    CrossrefPubMedGoogle Scholar
  • 23 Preidler KW, Peicha G, Lajtai G , et al. Conventional radiography, CT, and MR imaging in patients with hyperflexion injuries of the foot: diagnostic accuracy in the detection of bony and ligamentous changes. AJR Am J Roentgenol 1999; 173 (6) 1673-1677
    CrossrefPubMedGoogle Scholar
  • 24 Drakonaki EE, Kho JS, Sharp RJ, Ostlere SJ. Efficacy of ultrasound-guided steroid injections for pain management of midfoot joint degenerative disease. Skeletal Radiol 2011; 40 (8) 1001-1006
    CrossrefPubMedGoogle Scholar