Learning objectives
The objectives of this presentation are:
To become familiar with normal anatomy of Lisfranc ligament (educational illustrations)
To present ultrasound scanning technique and high-quality ultrasound images.
To become familiar with typical mechanisms of injuries of Lisfranc ligament
Background
The Lisfranc ligament extends obliquely between the dorso-lateral aspect of the first (medial) cuneiform to the dorso-medial aspect of the second metatarsal base.
It plays a major role in stabilization of the tarsometatarsal joints and is often injured in high-force plantofelxion trauma.
Complications of Lisfranc ligament injuries can result in posttraumatic osteoarthrosis and chronic foot pain.
Proper diagnosis is often delayed.
Rupture of Lisfranc ligament is often overlapping bony changes in this area (eg.
fracture of the 2nd metatarsal).
Findings and procedure details
The Lisfranc ligament extends obliquely between the dorso-lateral aspect of the first (medial) cuneiform to the dorso-medial aspect of the second metatarsal base.
This ligament can be easily visualized and evaluated using Ultrasound.
Probe should be placed transversally on the medial aspect of the foot.
Delicate tilting of the medial end of the probe helps to obtain the best image of the long axis of the ligament.
When injured,
Lisfranc ligament behavesexactly the same as other ligaments and ultrasound image reveals:
- Thick,
low-echogenicity of...
Conclusion
- Lisfranc ligament plays an important role in stabilization of tarsometatarsal joints.
- It is a superficial linear structure,
convenient to visualize in ultrasound examination.
Therfore,
ultrasonography can play a role in the assessment of posttraumatic midfoot pain and reliably exclude or confirm Lisfranc ligament injury.
References
Woodward,
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Morag,
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Fessell,
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Sonographic evaluation of Lisfranc ligament injuries.Journal of Ultrasound in Medicine,28(3),
351-357.
Kaicker,
J.,
Zajac,
M.,
Shergill,
R.,
& Choudur,
H.
N.
(2016).
Ultrasound appearance of the normal Lisfranc ligament.Emergency Radiology,23(6),
609-614.
Rettedal,
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D.,
Graves,
N.
C.,
Marshall,
J.
J.,
Frush,
K.,
& Vardaxis,
V.
(2013).
Reliability of ultrasound imaging in the assessment of the dorsal Lisfranc ligament.Journal of foot and ankle research,6(1),
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