Lisfranc injuries

Foot and Ankle Sports Medicine (M Drakos, section editor)
Part of the following topical collections:
  1. Topical Collection on Foot and Ankle Sports Medicine


Purpose of review

The purpose of this review is to discuss key anatomic and pathoanatomic factors, treatment principles, and patient outcomes of Lisfranc injuries.

Recent findings

Although open reduction and internal fixation (ORIF) remains the current gold standard of treatment, ORIF with primary arthrodesis has become increasingly popular in recent years, both for pure ligamentous and for bony–ligamentous injuries. Return to activity and competitive sports as well as overall patient outcomes have been further defined, suggesting that most patients are able to return to near pre-injury level if properly diagnosed and appropriately treated.


Considerable controversy remains as to the optimal method of treatment of Lisfranc injuries and may ultimately be defined by activity-specific or sport-specific criteria.


Lisfranc injury Tarsometatarsal joint complex Midfoot injury 


Compliance with ethical standards

Conflict of interest

Michael P. Clare declares that he has no conflict of interest.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Goossens M, DeStoop N. Lisfranc’s fracture-dislocations: etiology, radiology, and results of treatment. Clin Orthop Relat Res. 1983;176:154–62.Google Scholar
  2. 2.
    Gallagher SM, Rodriguez NA, Andersen CR, Granberry WM, Panchbhavi VK. Anatomic predisposition to Lisfranc injury: a matched case-control study. J Bone Joint Surg Am. 2013;95:2043–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Raikin SM, Elias I, Dheer S, Besser MP, Morrison WB, Zoga AC. Prediction of midfoot instability in the subtle Lisfranc injury. Comparison of magnetic resonance imaging with intraoperative findings. J Bone Joint Surg Am. 2009;91:892–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Meyer SA, Callaghan JJ, Albright JP, et al. Midfoot sprains in collegiate football players. Am J Sports Med. 1994;22:392–401.CrossRefPubMedGoogle Scholar
  5. 5.
    Curtis M, Myerson M, Szura B. Tarsometatarsal injuries in the athlete. Am J Sports Med. 1994;21:497–502.CrossRefGoogle Scholar
  6. 6.
    Sangeorzan BJ, Veith RG, Hansen ST. Salvage of Lisfanc’s tarsometatarsal joints by arthrodesis. Foot Ankle Int. 1990;4:193–200.CrossRefGoogle Scholar
  7. 7.
    Komenda GA, Myerson MS, Biddinger KR. Results of arthrodesis of the tarsometatarsal joints after traumatic injury. J Bone Joint Surg Am. 1996;78A:1665–76.CrossRefGoogle Scholar
  8. 8.
    Cassinelli SJ, Moss LK, Lee DC, Phillips J, Harris TG. Delayed open reduction internal fixation of missed, low-energy Lisfranc injuries. Foot Ankle Int 2016Google Scholar
  9. 9.
    Kadow TR, Siska PA, Evans AR, Sands SS, Tarkin IS. Staged treatment of high energy midfoot fracture dislocations. Foot Ankle Int. 2014;35:1287–91.CrossRefPubMedGoogle Scholar
  10. 10.
    Arntz CT, Hansen Jr ST. Dislocations and fracture dislocations of the tarsometatarsal joints. Orthop Clin North Am. 1987;18:105–14.PubMedGoogle Scholar
  11. 11.
    Ly TV, Coetzee JC. Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. A prospective, randomized study. J Bone Joint Surg Am. 2006;88:514–20.PubMedGoogle Scholar
  12. 12.
    Henning JA, Jones CB, Sietsema DL, Bohay DR, Anderson JG. Open reduction internal fixation versus primary arthrodesis for Lisfranc injuries: a prospective randomized study. Foot Ankle Int. 2009;30:913–22.CrossRefPubMedGoogle Scholar
  13. 13.
    Reinhardt KR, Oh LS, Schottel P, Roberts MM, Levine D. Treatment of Lisfranc fracture-dislocations with primary partial arthrodesis. Foot Ankle Int. 2012;33:50–6.CrossRefPubMedGoogle Scholar
  14. 14.
    • Smith N, Stone C, Furey A. Does open reduction and internal fixation versus primary arthrodesis improve patient outcomes for Lisfranc trauma? A systemic review and meta-analysis. Clin Orthop Relat Res. 2016;474:1445–52. Meta-analysis comparing ORIF to ORIF with primary arthrodesis CrossRefPubMedGoogle Scholar
  15. 15.
    • MacMahon A, Kim P, Levine DS, Burket J, Roberts MM, Drakos MC, Deland JT, Elliott AJ, Ellis SJ. Return to sports and physical activities after primary partial arthrodesis for Lisfranc injuries in young patients. Foot Ankle Int. 2016;37:355–62. Assesses return to vigorous activity in patients treated by ORIF and primary arthrodesis for Lisfranc injuries CrossRefPubMedGoogle Scholar
  16. 16.
    Deol RS, Roche A, Calder JD. Return to training and playing after acute Lisfranc injuries in elite professional soccer and rugby players. Am J Sports Med. 2016;44:166–70.CrossRefPubMedGoogle Scholar
  17. 17.
    McHale KJ, Rozell JC, Milby AH, Carey JL, Sennett BJ. Outcomes of Lisfranc injuries in the National Football League. Am J Sports Med. 2016;44:1810–7.CrossRefPubMedGoogle Scholar
  18. 18.
    • Dubois-Ferriere V, Lübbeke A, Chowdhary A, Stern R, Dominguez D, Assal M. Clinical outcomes and development of symptomatic osteoarthritis 2 to 24 years after surgical treatment of tarsometatarsal joint complex injuries. J Bone Joint Surg Am. 2016;98:713–20. Reviews clinical and radiographic outcomes following surgical treatment of Lisfranc injuries at medium- and long-term follow-up CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Foot and Ankle Fellowship|Florida Orthopaedic InstituteTampaUSA

Personalised recommendations