Language
Country/Area
No result found
The mysterious anatomy of a Lisfranc injury: How to identify this hidden danger in your feet? Click to find out!
A Lisfranc injury is a common and dangerous foot injury in which one or more of the bones of the foot dislocate from the ankle bone. The injury is named after French surgeon Jacques Lisfranc de St. Martin, who in 1815 noticed this fracture pattern in cavalrymen in combat. Although academic descriptions and research have long been accumulated, Lisfranc injuries still confuse many medical professionals.
Causes
The midfoot is made up of five bones that form the arch of the foot, primarily the cuboid, navicular, and three cuneiform bones. The joints between these bones and the bases of the five foot bones are the key sites for Lisfranc injuries. These injuries usually involve the ligaments between the bones, specifically a structure medically known as the Lisfranc ligament.
“Lisfranc injuries are often caused by excessive kinetic energy being applied to the midfoot.”
These injuries often occur in traffic accidents or industrial accidents. Direct Lisfranc injuries usually occur when a heavy object is placed on the foot, the foot is run over by a vehicle, or the foot falls on the foot after a fall from a height. Indirect injuries are often caused by the sudden rotation of the foot when it is stretched downward, such as when a rider falls off his horse but his foot is caught in the saddle.
Diagnostic Methods
In the setting of high-energy midfoot injuries, such as falls or traffic accidents, the diagnosis of a Lisfranc injury should theoretically not be difficult. The midfoot will be deformed and the abnormalities will be relatively obvious on X-rays. However, in low-energy events, such as an accidental sprain on the playing field, diagnosis becomes complicated. At this point, the patient may only complain of inability to bear weight and mild swelling.
“For apparently normal X-rays, if clinical suspicion persists, an MRI or CT scan is the ideal next step.”
Traditional X-ray examinations usually begin with standard non-weight-bearing images, supplemented with weight-bearing images to examine the gap between the first and second toes.
Rating
Lisfranc injuries can be divided into three main types, depending on the severity of the injury: ipsilateral, isolated, and radiating. These classifications play a key role in diagnosis and treatment.
Treatment methods
Treatment options include surgical and nonsurgical methods. One study showed that in athletes, if the dislocation is 2 mm or less, six weeks of casting with no weight bearing is sufficient. In most cases, early surgery to align the bone fragments (open reduction) and stabilize them is necessary.
"For severe Lisfranc injuries, open reduction and internal fixation is the treatment of choice."
During the treatment process, patients need to follow the guidance of professional medical staff and undergo rehabilitation training to speed up recovery.
Case History
During the Napoleonic Wars, Jacques Lisfranc encountered a soldier who had suffered vascular damage after falling from his horse. He subsequently performed an amputation and the part became known as the "Lisfranc joint." Although Lisfranc did not describe the mechanism or classification of this injury in detail at the time, the term is still closely associated with these fractures and dislocations to this day.
Lisfranc injuries are not limited to sports or accidents; they can also lurk in everyday life, causing inconvenience and pain to daily movements. Are you aware of the potential ankle risks in your daily activities?
