Diagnosis and management of lisfranc injuries and metatarsal fractures

R I Med J (2013). 2013 May 1;96(5):33-6.

Abstract

Forefoot and midfoot injuries are relatively common and can lead to chronic disability, especially if they are not promptly diagnosed and appropriately treated. A focused history and physical examination must be coupled with a thorough review of imaging studies to identify the correct diagnosis. Subtle radiographic changes can represent significant ligamentous Lisfranc injury. Midfoot swelling in the presence of plantar ecchymosis should be considered to be a Lisfranc injury until proven otherwise. While most metatarsal fractures can be treated with some form of immobilization and protected weight-bearing, this article will distinguish these more common injuries from those requiring surgical intervention. We will review relevant anatomy and biomechanics, mechanisms of injury, clinical presentation, imaging studies, and diagnostic techniques and treatment.

Keywords: Lisfranc joint injury; metatarsal fracture.

MeSH terms

  • Disability Evaluation
  • Early Diagnosis
  • Foot Injuries / diagnosis*
  • Foot Injuries / physiopathology
  • Foot Injuries / rehabilitation
  • Fracture Fixation, Internal
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / physiopathology
  • Fractures, Bone / rehabilitation
  • Humans
  • Joint Instability
  • Ligaments, Articular / diagnostic imaging
  • Ligaments, Articular / injuries*
  • Metatarsal Bones / diagnostic imaging
  • Metatarsal Bones / injuries*
  • Physical Examination*
  • Tarsal Bones / diagnostic imaging
  • Tarsal Bones / injuries
  • Tarsal Joints / diagnostic imaging
  • Tarsal Joints / injuries*
  • Tomography, X-Ray Computed*
  • Weight-Bearing