Lisfranc Fracture (Symptoms and Causes)

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The midfoot gets no respect. While people can relate to a stubbed toe or sprained ankle; the part of the foot that connects the two, and is responsible for helping absorb the shock of walking, running, and jumping isn't given much thought. Not so for the French surgeon Jacques Lisfranc de St. Martin, a surgeon in Napolean's army. Dr. Lisfranc studied the midfoot bones, the joints where they connected, and the ligaments that held them together. Understanding that anatomy led to his name being attached to the classic Lisfranc fracture dislocations that occurred when horsemen fell and their foot was trapped in the stirrup.

Most people, including doctors (except for orthopedic and podiatric surgeons) quickly forget or vaguely remember about the row of bones between the ankle and the metatarsal bones (the long thin bones that lead from the toes to the middle of the foot). But the relationship of the cuneiforms and the cuboid bones allow the foot to disperse the energy and shock that is generated by the weight of the body. A Lisfranc injury disrupts those joints that hold the midfoot stable.

Picture of the Bones in the Foot

While history said that the injury was equestrian in origin, the most common cause of a Lisfranc fracture is stepping into a hole and falling forward. The toes of the foot are trapped and pointed downward, and in car accidents the foot is trapped and rotates. This is also the same mechanism that can occur in football, where a pointed toe gets caught and an opponent falls onto the back of the heel, most often damaging the Lisfranc joint.