What is a Lisfranc injury?

A rare injury manifest by misalignment of the tarsometatarsal joint of the foot

Standard AP, lateral, and oblique films usually diagnostic

• Medial border of the 2nd metatarsal should be co-linear with the medial border of the middle cuneiform on the AP view
  
• Medial border of the 4th metatarsal should be co-liner with the medial border of the cuboid on the oblique view
  
• Dorsal displacement of the metatarsals on the lateral view is indicative of ligamentous compromise
  
• Fractures at the base of the 2nd metatarsal are indicative of Lisfranc joint disruption
• Click here for primer on foot bone anatomy
  

Treatment

• Ortho consult
  
• Minimal displacement - cast; otherwise operative
  

Clinical significance

• If not appropriately diagnosed and treated severe post traumatic arthritis may ensue

Source

Koval, K. MD and Zuckerman, J. MD Handbook of Fractures. 2nd ed.