Lisfranc Injury Malanga Talks

During today's episode, we will discuss the characteristics of the Lisfranc injury. This will include the history, physical examination, pathophysiology,  diagnostic criteria, and management options. What is a Lisfranc injury? A Lisfranc injury is when a tarsometatarsal dislocation occurs by traumatic disruption between the articulation of the medial cuneiform and the second metatarsal bone. This usually occurs through some traumatic event where an individual provides an excessive axial load through a hyperplantar flexed forefoot. The force exerted on the forefoot is transmitted to the tarsometatarsal joint causing the metatarsals to be displaced in a dorsal and lateral direction. The diagnostic criteria include midfoot pain and a widening interval between the 1st and 2nd metatarsal bone on AP view x-ray. Depending on the severity of the injury and x-ray findings, nonoperative or operative management should be discussed with the patient to receive the best outcome. We hope you enjoy this educational discussion on Lisfranc injuries. 

 

Time Stamp

· Intro (0:00)

· Dr. Josh Martin Introduction (0:25)

· The history and anatomy of the Lisfranc joint complex (0:50)

· Mechanism of injury behind Lisfranc injuries (1:45)

· Acquiring an orthopedic medical history (3:05)

· Physical examination (4:45)

· Pathology that occurs with excessive eversion (7:55)

· What is a Lisfranc fracture? (10:00)

· X-ray findings associated with Lisfranc injuries (10:30)

· Determining non-operative vs. operative management based on X-ray findings (11:20)

· Non-operative treatment options (11:50)

· Operative treatment options and post-operative recommendations (12:40)

· Is there a role for cortisone injections for Lisfranc injuries? (14:20)

· Physician’s obligation to the patient/athlete in his/her health (16:00)

· Closing remarks (17:40)