One should also ensure the injury is closed as open fracture-dislocations are a surgical emergency. Pain can also commonly be reproduced with passive pronation or supination of the tarsometatarsal joint. There is often pain with combined abduction and eversion of the forefoot. There is typically pain with palpation over the dorsal mid-foot, more specifically the tarsometatarsal joints. Inspection of the affected foot can reveal significant swelling, ecchymosis, and although less common, obvious anatomic deformity. The physical exam can be very helpful and suggestive of these injuries. If there is midfoot pain beyond five days, swelling, and/or difficulty with push-off activities, then a Lisfranc injury should be highly suspected. It is important to note that the severity of the injury is often underestimated at the time of initial injury and the presentation may be delayed. The pain is classically worsened by forefoot weight bearing, and the patient may describe pain or difficulty with the push-off phases of walking and/or running. The injury will often occur by one of the mechanisms described previously. Usually, the patient will complain of midfoot pain with varying amounts of pain with weight-bearing, following an acute injury. Even when recognized and treated promptly, there is still a high risk for chronic disability and complications. It is important to recognize these injuries early and start treatment promptly because failure to recognize and treat these will lead to midfoot arthritis, chronic pain, and functional instability. Lisfranc joint injuries are uncommon and are often misdiagnosed and mismanaged. Although a Lisfranc injury can involve various parts of the foot the Lisfranc ligament itself is an isolated ligament that connects the medial cuneiform to the second metatarsal. Injuries of the joint can range from complete tarsometatarsal displacement with associated fractures and ligamentous tears to partial sprains with no displacement. The Lisfranc joint itself is composed of the articulation between the first, second, and third metatarsals bones, and the cuneiform bones. This activity describes the pathophysiology, evaluation, and management of Lisfranc joint injuries and highlights the role of the interprofessional team in the care of affected patients.Ī Lisfranc dislocation or injury typically describes a spectrum of injuries involving the tarsometatarsal joints of the foot. The Lisfranc joint is comprised of the articulation between the first, second, and third metatarsals bones and the cuneiform bones. A Lisfranc dislocation or injury describes a spectrum of injuries involving the tarsometatarsal joints of the foot.
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