1. Describe a Lisfranc injury and its classification. 2. Recognize the clinical signs of a Lisfranc injury. 3. Discuss pertinent imaging findings in conventional radiography, computed tomography (CT) and magnetic resonance imaging (MRI).

I.Introduction The Lisfranc joint complex is an essential component for midfoot and forefoot stability. Lisfranc injuries can be classified depending on the etiology of the injury. High impact injuries, also called Lisfranc Fracture-Displacement, occur as a result of motor vehicle trauma and carry a high morbidity. Low impact injuries, also called Lisfranc Injuries or Midfoot Sprains, are common among athletes. A significant amount of Lisfranc injuries (35%) are initially missed due to soft tissue swelling or being overlooked due to multiple injuries. A delay on...

I. Clinical Presentation Lisfranc injuries may present with varying degrees of swelling on the midfoot. There are several clinical signs that could indicate a Lisfranc injury including midfoot pain while walking downstairs and pain upon palpation of the dorsal aspect of the tarsometatarsal joints. Plantar ecchymosis has been considered pathognomonic for a Lisfranc injury and should initiate a rigorous evaluation. II. Conventional Radiography Conventional radiography is the initial study on the evaluation of Lisfranc Injuries. Images should be obtained in anteroposterior (AP), lateral and 30°internal...

Lisfranc joint complex, composed of nine bones and the three parts of the lisfranc ligament, is essential for midfoot and forefoot stability. The second metatarsal is the key component of the Lisfranc joint complex, articulating with C1 and C3. The dorsal component of the Lisfranc ligament is the weakest part explaining why most injuries result in dorsal displacement. Lisfranc injuries are classified by the injury pattern into high impact or low impact injuries. A significant amount of Lisfranc injuries are missed due to extensive swelling...

Crim, J. (2008). MR Imaging Evaluation of Subtle Lisfranc Injuries: The Midfoot Sprain. Magnetic Resonance Imaging Clinics of North America,16(1), 19-27. doi:10.1016/j.mric.2008.02.007 Hatem, S. F. (2008). Imaging of Lisfranc Injury and Midfoot Sprain. Radiologic Clinics of North America,46(6), 1045-1060. doi:10.1016/j.rcl.2008.09.003 Li, H., Chen, Y., Qiang, M., Zhang, K., Jiang, Y., Zhang, Y., & Jia, X. (2017). Evaluation of computed tomography post-processing images in postoperative assessment of Lisfranc injuries compared with plain radiographs. Journal of Orthopaedic Surgery and Research,12(1). doi:10.1186/s13018-017-0589-9 Potter, H. G., Deland, J. T.,...