Lisfranc Injury Flashcards

1
Q

Define a Lisfranc injury?

A

Disruption of the articulation between the medial cuneiform and the base of the second metatarsal

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2
Q

What is the anatomy and function of the Lisfranc ligament?

A

Spans from medial cunieform to the base of the second metatarsal.
Stabilizes the 2nd MT and midfoot arch

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3
Q

What are the five critical radiographic signs that indicate midfoot instability?

A
AP:
1) Malalignment of medial margin of 2nd MT base and medial side of middle cunieform
2) Fleck sign in 1st MT web space
3) Widening of interval btw 1st and 2nd MT base
Lateral:
4) Dorsal subluxation of 1st or 2nd MT
Oblique:
5) Malalignment of 4th MT and cuboid
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4
Q

What are the treatment options for Lisfranc?

A

Non-op: no instability with WB films, or CT evidence of disruption
Operative: ORIF, arthrodesis of 1st, 2nd and 3rd MTPs, midfoot arthrodesis

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5
Q

What considerations are made when choosing between ORIF and arthrodesis for a Lisfranc injury?

A

Either if >2mm shift
Purely ligamentous injuries- arthrodesis
Fracture dislocation- ORIF

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6
Q

What advantages does arthrodesis have over ORIF in Lisfranc injuries?

A

Equivalent outcomes with fewer hardware issues or revision

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7
Q

What is the treatment for a chronic Lisfranc injury?

A

Midfoot arthrodesis

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