Effective detection and management of low-velocity Lisfranc injuries in the emergency setting: principles for a subtle and commonly missed entity

Can Fam Physician. 2012 Nov;58(11):1199-204, e620-5.
[Article in English, French]


Objective: To improve the ability of primary care physicians to recognize the mechanisms and common presentations of low-velocity Lisfranc injuries (LFIs) and to impart an improved understanding of the role of imaging and principles of primary care in low-velocity LFIs.

Sources of information: A MEDLINE literature review was performed and the results were summarized, reviewing anatomy and mechanisms, clinical and imaging-based diagnoses, and management principles in the primary care setting.

Main message: Low-velocity LFIs result from various mechanisms and can have very subtle findings on clinical examination and imaging. A high degree of suspicion and caution are warranted when managing this type of injury.

Conclusion: Although potentially devastating if missed, if a few treatment principles for low-velocity LFIs are applied from the initial presentation onward, outcomes from this injury can be optimized.

Publication types

  • Review

MeSH terms

  • Diagnostic Errors / prevention & control*
  • Diagnostic Imaging
  • Emergency Service, Hospital
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / therapy
  • Humans
  • Joint Dislocations / diagnosis*
  • Joint Dislocations / therapy
  • Ligaments / injuries*
  • Metatarsal Bones / injuries*
  • Physical Examination
  • Splints
  • Tarsal Joints / injuries*
  • Weight-Bearing