Midfoot Injuries
A 32-year-old man presents after a motorcycle accident with pain and swelling in his midfoot. He cannot bear weight. On examination, there is plantar ecchymosis and tenderness at the tarsometatarsal (TMT) joint. Weight-bearing radiographs show widening between the first and second metatarsal bases with a small avulsion fragment medial to the base of the second metatarsal. CT confirms displacement at the Lisfranc joint complex. Regarding Lisfranc fracture-dislocation:
Mark each as TRUE or FALSE
The Lisfranc joint is the tarsometatarsal articulation; the Lisfranc ligament is the key stabilizer ...
The "fleck sign" is an avulsion fragment from the base of the second metatarsal or medial cuneiform ...
The Lisfranc ligament connects the first to the third metatarsal; the first TMT joint is the keyston...
Treatment options include ORIF (screws or plates) for purely ligamentous injuries and anatomic reduc...
Complications include post-traumatic arthritis (very common, even with anatomic reduction), chronic ...
Answer the questions to see explanations
Click T (True) or F (False) for each option