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Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot
  1. Simon Lau1,
  2. Michael Bozin2,
  3. Tharsa Thillainadesan1
  1. 1Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
  2. 2General Surgical and Trauma Registrar, Royal Melbourne Hospital, Parkville, Victoria, Australia
  1. Correspondence to Dr Simon LauRoyal Melbourne Hospital, Orthopaedic Office, Level 7 East, Grattan Street, Parkville VIC 3050, Australia; drsimonchlau{at}gmail.com

Abstract

Musculoskeletal trauma to the foot is a common presentation to EDs. A Lisfranc fracture dislocation involves injury to the bony and soft tissue structures of the tarsometatarsal joint. While it is most commonly seen post high velocity trauma, it can also present post minor trauma. It is also misdiagnosed in approximately 20% of cases. These Lisfranc injuries typically present to EDs with pain particularly with weight bearing, swelling and post a characteristic mechanism of injury. Diagnosis is via clinical examination and radiological investigation—typically plain radiographs and CTs. Once diagnosed, Lisfranc injuries can be classified as stable or unstable. Stable injuries can be immobilised in EDs and discharged home. Unstable injuries require an orthopaedic referral for consideration of surgical fixation.

  • assessment
  • clinical assessment
  • clinical assessment, education
  • Trauma, extremity
  • Trauma, epidemiology

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Footnotes

  • Contributors SL: study design and manuscript production/writing. MB: study design, editing and supervision. TT: study design and editing.

  • Competing interests None declared.

  • Ethics approval Melbourne Health Human Research Ethics Committee (HREC), Royal Melbourne Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.