Lisfranc Fracture

What is a Lisfranc fracture, and what are my treatment options?

A Lisfranc fracture is a painful condition that affects the middle of your foot. In this article, we will discuss what Lisfranc fractures are, the types of Lisfranc joint injuries, potential causes, symptoms, diagnosis, and treatment options.

If you’re looking for orthopedic care for a foot injury, contact our orthopedic surgeons at OrthoNeuro. You can find us in various locations throughout the Greater Columbus, Ohio area.

What is a Lisfranc Fracture?

A Lisfranc fracture is a specific type of injury that affects the midfoot region, particularly the tarsometatarsal joint complex. This complex is made up of strong ligaments that hold the 5 metatarsal bones of the foot that extend to the toes. Due to its location, it can also be referred to as a midfoot sprain.

Injuries usually involve the ligaments between the medial cuneiform bone and the bases of the second and third metatarsal bones. Each one of these ligaments is called a Lisfranc ligament.

The tarsometatarsal joint complex, also known as the Lisfranc joint complex, plays a vital role in foot stability and movement. Lisfranc injuries can vary in severity, and understanding them is crucial for effective treatment.

Types of Lisfranc Joint Injuries

Lisfranc injuries can include strains and tears to the Lisfranc ligaments. More severe Lisfranc injuries can include fractures and dislocations of the bone, referred to as Lisfranc fracture-dislocations.

Lisfranc injuries can take various forms, ranging from subtle to severe. The types of Lisfranc injuries include:

Low-Energy Lisfranc Injury

These can result from a simple twist and fall, and they are often seen in activities such as football and soccer when one player lands on another player’s foot while it is flexed downward as the player is pushing off to run. This type of injury usually only causes a ligamentous injury.

High-Energy Lisfranc Injuries

These are more likely to occur due to direct trauma, such as falls from heights or motor vehicle collisions. They are more likely to lead to a Lisfranc fracture-dislocation. This could include multiple foot fractures and joint dislocations.

Causes of Lisfranc Injuries

Lisfranc injuries are usually caused by traumatic injury. They can occur in low-energy and high-energy events. A low-energy Lisfranc injury can occur with a simple twist and fall. A severe injury is likely to result from a high-energy event.

Symptoms of Lisfranc Fracture

There are some common symptoms of Lisfranc fracture to look out for.

Common symptoms of a Lisfranc joint complex injury include:

  • Swelling and pain on the top of the foot.
  • Bruising on both the top and bottom of the foot, with bottom bruising strongly suggesting a Lisfranc injury.
  • Midfoot pain that worsens with standing, walking, or attempting to push off on the affected foot, often making weight-bearing impossible.

If you experience persistent pain and swelling or cannot bear weight after a potential injury, contact our orthopedic surgeons at OrthoNeuro.

Diagnosing Lisfranc Injury

Diagnosing a Lisfranc joint injury usually involves a thorough medical history, physical examination, and imaging tests:

  • Medical History and Physical Examination: Your doctor will discuss your symptoms and conduct physical tests to assess tenderness, pain with stress examinations, and other signs that may indicate a Lisfranc injury.
  • Imaging Tests: These may include X-rays to visualize broken bones and assess joint alignment. In some cases, an MRI or CT scan might be recommended for a more detailed view of soft tissues and ligaments.

How is a Lisfranc Injury Treated?

Treatment of a Lisfranc injury depends on the injury’s severity. Your treatment could involve non-surgical or surgical options.

  • Nonsurgical Treatment: For less severe cases without fractures or joint dislocations, non-weight-bearing cast or boot immobilization for 6 to 8 weeks may be sufficient. Strict adherence to non-weight-bearing is crucial. If bones shift during follow-up, surgery may be needed.
  • Surgical Treatment: Displaced fractures or joint instability require surgery. One procedure used to correct this is open reduction and internal fixation (ORIF). The procedure realigns and secures bones with plates or screws. Another treatment option is midfoot fusion used to eliminate joint movement.

Complications of Lisfranc Injury

Complications can arise from Lisfranc fractures, including chronic pain, secondary disability, and post-traumatic arthritis. Close follow-up with your healthcare provider is essential to monitor healing and address any potential issues.

For example, damage to cartilage can lead to arthritis as joint surfaces are less protected. Fallen arches are another problem that can develop with Lisfranc injury which may require further surgery. Therefore, close follow-up with your healthcare provider is essential to monitor healing and address any potential issues.

Book Your Visit Today

Lisfranc fractures can vary in severity and require prompt diagnosis and appropriate treatment. Your orthopedic surgeon will work with you to determine the best course of action for your specific injury.

Remember that recovery is possible, and with proper care, you can regain function and minimize long-term complications. If you have any concerns about Lisfranc injuries or related conditions, do not hesitate to contact our expert orthopedic surgeons at OrthoNeuro in Columbus, OH today!


Medically reviewed by Jeffrey E. Gittins, D.O.

Foot, Ankle, and Podiatry Specialists


Nicholas A. Cheney, DO, FAOAO

Orthopedic Foot & Ankle Surgeon

Jeffrey E. Gittins, DO

Orthopedic Surgeon

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