Lisfranc Injuries Explained: Midfoot Instability, X-Ray Clues & Treatment

About this video

Lisfranc injuries are easy to underestimate because the foot can look like a simple sprain while the midfoot arch is already unstable. This Orthovellum visual explainer walks through the anatomy, mechanism, clinical red flags, imaging clues, and treatment logic behind Lisfranc injury assessment. In this episode, we cover how the Lisfranc joint complex links the metatarsals to the cuneiforms and cuboid, why the second metatarsal base behaves like a keystone, and how the Lisfranc ligament helps hold the medial cuneiform to the second metatarsal base. The video explains why a planted forefoot twist, axial load, fall, sport injury, or crush injury can disrupt the midfoot even when the first impression is just foot pain or a foot sprain. Clinical topics include midfoot swelling, tenderness, painful push-off, inability to bear weight normally, and plantar bruising as an important warning sign. Imaging topics include AP, oblique, lateral, and weight-bearing radiographs, comparison views, widening between the first and second rays, malalignment at the second metatarsal and middle cuneiform, the fleck sign, CT for fracture mapping, and MRI for ligament injury. Treatment discussion focuses on the central question: is the Lisfranc injury stable or unstable? Stable patterns may be managed differently from displaced or unstable injuries, while unstable injuries often need fixation, fusion, or other orthopaedic surgical planning. The goal is to protect the midfoot arch, avoid missed instability, and reduce the risk of long-term pain, collapse, and arthritis. Watch this if you are studying orthopaedics, emergency medicine, radiology, sports injury assessment, foot and ankle surgery, or medical education around midfoot trauma. Explore more orthopaedic visual explainers at Orthovellum.com. Subscribe to Orthovellum for detailed visual medical education in orthopaedics. Educational only. This is not personal medical advice. For symptoms or injury care, speak with a qualified clinician. Sources and reference anchors used for educational framing: AAOS OrthoInfo, Merck Manual Professional, and NCBI Bookshelf / StatPearls. #LisfrancInjury #MidfootInjury #FootInjury #FootFracture #FootXray #Orthopedics #Orthopaedics #OrthopedicSurgery #Radiology #MedicalEducation #Orthovellum