Biomechanical and Radiographic Tools in Assessing Subtle Injuries to Lisfranc Joint

The defi nition of Lisfranc’s joint is the articulation between the bases of the metatarsals and the cuneiforms medially and the cuboid laterally. Unlike the lesser metatarsals, the fi rst and second metatarsals are not anchored to each other with an intermetatarsal ligament; rather, they are connected indirectly via Lisfranc’s ligament. Lisfranc’s ligament connects the lateral aspect of the medial cuneiform to the medial aspect of the base of the second metatarsal. Disruption of this ligament due to low energy mechanisms of injury can result in subtle clinical and radiographic fi ndings often going undiagnosed. Missed diagnosis has tremendous consequences resulting in rapid development of midfoot osteoarthritis and fl attening of the medial longitudinal arch of the foot. Accurate, timely diagnosis and appropriate treatment are paramount in successful management of tarsal metatarsal joint injuries.