Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot

Musculoskeletal trauma to the foot is a common presentation to EDs. A Lisfranc fracture dislocation involves injury to the bony and soft tissue structures of the tarsometatarsal joint. While it is most commonly seen post high velocity trauma, it can also present post minor trauma. It is also misdiagnosed in approximately 20% of cases. These Lisfranc injuries typically present to EDs with pain particularly with weight bearing, swelling and post a characteristic mechanism of injury. Diagnosis is via clinical examination and radiological investigation-typically plain radiographs and CTs. Once diagnosed, Lisfranc injuries can be classified as stable or unstable. Stable injuries can be immobilised in EDs and discharged home. Unstable injuries require an orthopaedic referral for consideration of surgical fixation.