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Lisfranc Injury

Lisfranc Injury
Figure showing widening of the space between the 1st and 2nd metatarsals characteristic of a Lisfranc injury.

Jacques Lisfranc de St Martin was a surgeon in Napoleon’s Army and first described the lisfranc injury in 1813. A common mechanism then was falling from a horse whilst trapping their foot in the stirrup. This resulted in a fracture at the base of the second metatarsal and separation of the metatarsals. The injury is nowadays most commonly seen in sports people especially rugby players. Pain and swelling in the midfoot following an external rotation injury usually during a tackle are signs highly suggestive of a Lisfranc injury. The diagnosis is made with x-rays and CT scans. Undisplaced fractures can be treated non-operatively but displaced fractures require fixation. A delay in treatment adversely affects the outcome so early diagnosis is very important.