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Foot & Ankle
intermediate
X-Type

Lisfranc Injuries - Anatomy, Fleck Sign and Open Reduction Internal Fixation

Foot Trauma

A 28-year-old footballer sustains a midfoot injury when an opponent lands on his heel while his foot is plantarflexed. He presents with severe midfoot pain, swelling, and inability to weight-bear. Plain radiographs show widening between the base of the first and second metatarsals with a small avulsion fracture (fleck sign). CT scan confirms complete disruption of the Lisfranc ligament complex with 5mm diastasis between M1 and M2 bases. The foot and ankle surgeon discusses the anatomy of the tarsometatarsal joint complex, classification, and the importance of anatomic restoration. Regarding Lisfranc injuries:

Mark each as TRUE or FALSE

A

The LISFRANC (tarsometatarsal) joint complex comprises the articulations between the cuneiforms/cubo...

B

The FLECK SIGN (small avulsion fracture from base of second metatarsal or medial cuneiform) indicate...

C

The FIRST metatarsal base is the keystone; a ligament directly connects M1 to M2; fleck sign is alwa...

D

Lisfranc injuries are classified as HOMOLATERAL (all MTsaligned in same direction), ISOLATED (single...

E

Treatment: ORIF for displaced injuries (greater than 2mm diastasis or any instability) using SCREWS ...

Answer the questions to see explanations

Click T (True) or F (False) for each option