Lisfranc’s Injury

Lisfrancs injury fracture

Lisfranc’s injury is a dislocation or fracture in the midfoot area. It occurs in the joint where the short metatarsal bones meet the long bones in the foot. Swelling on the top of the foot and pain when weight is placed on the foot are the main symptoms. This foot injury is very rare but it is vital that it is not missed as long-term damage can occur.


Lisfranc’s injury symptoms

  • Symptoms of Lisfranc’s injury include pain in the midfoot area with difficulty putting any weight on the foot.
  • There may be some bone deformity visible but this is not always the case.
  • Swelling is likely on the top of the foot and there will be tenderness over the joint area.
  • Pain will be increased when pushing up onto the toes or performing a calf raise exercise.

What is a Lisfranc injury?

The term Lisfranc’s joint refers to the tarsometatarsal joints where the short tarsal bones in the midfoot meet the long bones or metatarsals in the foot. Jaques Lisfranc was a surgeon in Napoleon’s army who described an operation for amputation through this joint.

Lisfranc’s injury, or Lisfranc’s fracture-dislocation, is rare in sport but if left untreated it can have very severe consequences. If a midfoot sprain is suspected then Lisfranc’s injury should also be considered. The most common cause of this injury is stepping into a small hole, which causes a strong twisting force with a lot of body-weight on top. It can also happen in car accidents.

Lisfranc’s ligament connects the medial cuneiform bone (one of the tarsals) to the base of the 2nd metatarsal. The injury may consist of a dislocation where there is only ligament damage, or a fracture of one of the two bones may also occur.


  • If you suspect a Lisfranc’s injury or even a midtarsal joint sprain, then seek medical advice immediately. Delaying treatment of Lisfranc’s injury can cause long term or permanent damage.
  • A doctor will X-ray the foot with the athlete in a weight-bearing position. However, this injury is often missed even with an x-ray, so if the therapist suspects Lisfranc’s injury and it is not obvious through X-ray then MRI or bone scan is required to confirm the diagnosis.
  • If Lisfranc’s injury is confirmed, a plaster cast with a toe plate extending under the toes is applied below the knee to immobilize the joint. Sometimes the bones require fixing with pins or wires.
  • Treatment will then depend on the severity of the injury. Precise anatomic reduction of the bones is required. If this is the case then the cast is usually on for 4 to 6 weeks. After this time general foot and lower leg rehabilitation exercises are done to restore mobility, strength, and proprioception.

Related articles

  • Foot pain

    Here we explain the common causes of foot pain including heel, forefoot, arch, top of the foot and toes. Click on headings to expand: Heel…

  • Foot stress frqacture

    A stress fracture is a hairline fracture in a bone caused by overuse. In the foot, the Navicular stress fracture is the most common but…

  • Osteochondral lesions of the talus

    Osteochondral lesions of the talus are fractures of the cartilage, which sits on top of the Talus (ankle bone). They commonly occur in combination with…

  • Forefoot and ball of the foot pain

    Forefoot pain includes injuries to the long metatarsal bones in the foot, inside, outside and under the ball of the foot. Here we explain the…

  • Foot arch pain

    Here we explain causes of midfoot pain. Pain in the middle of the foot can develop gradually through overuse, or suddenly following direct trauma such…

  • Overpronation

    Overpronation is often recognised as a flattening or rolling in of the foot but it is not quite as simple as that. If you overpronate,…

Scroll to Top