Junior call case 12

The Lisfranc fracture-dislocation has gained educational importance, because 1) it is a commonly missed diagnosis and 2) it leads to severe disability if left untreated.

• The Lisfranc ligament connects the 1st cuneiform to the 2nd metatarsal base.

• AP view: look for the alignment of the medial borders of the 2nd and 3rd metatarsals with their respective cuneiforms.

• Lateral view, WEIGHT-BEARING: dorsal displacement of the metatarsal bone

• Two types:

• Homolateral (Convergent): metatarsals move in same direction, occurs in trauma
• Divergent: metatarsals move in different directions, occurs in diabetic neuropathy

• Complication = DORSALIS PEDIS artery injury