LISFRANC FRACTURE-DISLOCATION: A CASE REPORT

The tarsometatarsal joint is an anatomic area where a wide spectrum of injuries can occur. Regarding

the damage mechanism, indirect injuries are more frequent and usually occur during bending or

twisting movements applied to the midfoot. This mechanism is very common in sports but also

possible in household accidents and falls. Patients can present with pain localized in the midfoot

which can include swelling and functional disability to bear weight after trauma. Due to the diversity

of injuries, there is no single evidence-based policy for treating all Lisfranc injuries in a similar

manner. The goal of initial presentation of these injuries is directed towards improving the overall

alignment of the foot. The diagnosis can be made by evaluating anteroposterior, lateral and 30°

oblique X-rays of the foot bearing weight because in some cases the instability will only be evident

after load is placed on the feet; minor displacement and smaller fractures may only be detected with

CT or MRI. The diagnosis can be difficult and it is missed in up to one third of cases. It is important

to recognize these injuries early and start treatment promptly because delayed treatment can lead to

chronic pain, functional disability and, in some cases, to medical liability. This case illustrates a

traumatic Lisfranc injury misdiagnosed at initial evaluation, which led to chronic pain and permanent

functional disability. The aim of this paper is to raise awareness of this rare injury for orthopedic

surgeons to avoid cases of malpractice claims and medical liability