The Lisfranc Joint is the midfoot complex where the metatarsal bones connect to the tarsal bones. Injury to this region of the foot can range from a ligament sprain to a severe fracture dislocation of the joint.
These injuries often occur from a twisting mechanism of the midfoot, a fall with the foot pointed in a downward direction or even a misstep such as stepping into a pothole or on an uneven surface. Lisfranc injuries are very common in football players, where the player gets stepped on or tackled with the foot planted in the ground. Basketball and volleyball players are prone to this injury with quick pivoting motions and coming down on a foot pointed in a downward position.
Patients often mistake it for a simple foot sprain, which can delay the diagnosis. The lisfranc joint acts like the foundation of a bridge for the foot. If it becomes unstable, the entire structure of the foot can be affected, The common symptoms of a lisfranc injury include midfoot pain, either on the top or bottom of the midfoot. There is associated swelling and bruising across the midfoot. There is usually an increase in pain when standing or walking with difficulty in bearing weight on the foot.
The most important stabilizing structure of the joint is the Lisfranc Ligament. This ligament connects the medial cuneiform (midfoot bone) to the base of the second metatarsal bone.
A proper evaluation of the injury will focus on a physical exam of the foot to determine midfoot tenderness and stability. Weightbearing x-rays are very important to detect any subtle instability of the joint or disruption of the lis franc ligament. A CT scan can be helpful in evaluating bone alignment and an MRI to assess ligament damage.
If left untreated, Lisfranc injuries can lead to chronic midfoot pain, arch collapse, arthritis of the midfoot joints and long term difficulty in walking.
If you are experiencing persistent midfoot pain following an injury, schedule an evaluation with a Podiatrist. Early diagnosis is critical for proper healing and long term function.
I am Dr. Joseph A. Cione, board certified foot surgeon with Advanced Footcare, proudly serving patients in Woodbury, Baldwin and Manhasset.
