A Lisfranc fracture, also known as Lisfranc injury, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus.
The midfoot consists of five bones that form the arches of the foot (the cuboid, navicular, and three cuneiform bones) and their articulations with the bases of the five metatarsal bones, and these articulations are damaged in a Lisfranc injury. Such injuries typically involve the ligaments between the medial cuneiform bone and the bases of the second and third metatarsal bones, and each of these ligaments is called Lisfranc ligament.
Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot and are often seen in traffic collisions or industrial accidents. Direct Lisfranc injuries are usually caused by a crush injury, such as a heavy object falling onto the midfoot, or the foot being run over by a car or truck, or someone landing on the foot after a fall from a significant height.
Indirect Lisfranc injuries are caused by a sudden rotational force on a plantar flexed (downward pointing) forefoot. Examples of this type of trauma include a rider falling from a horse but the foot remaining trapped in the stirrup, or a person falling forward after stepping into a storm drain.
In athletic trauma, Lisfranc injuries occur commonly in activities such as windsurfing, kitesurfing, wakeboarding, or snowboarding (where appliance bindings pass directly over the metatarsals). American football players occasionally acquire this injury, and it most often occurs when the athlete’s foot is plantar flexed and another player lands on the heel. This can also be seen in pivoting athletic positions such as a baseball catcher or a ballerina spinning.
