Download Lisfranc Fracture Author: Russell Jones, MD

Lisfranc Fracture
1. Always obtain 3 views of the foot: AP, lateral, and 30 degrees oblique
2. Weight bearing views can show subtle widening of articulation spaces
and point out instability due to lisfranc ligamentous injuries
3. On the AP view, any diastasis of more than 2mm between the base of
the 1st and 2nd metatarsals suggest Lisfranc injury
4. On the lateral view, the superior border of the base of the first
metatarsal should align with the superior border of the medial
cuneiform
5. On the oblique view, the medial border of the fourth metatarsal
should align with the medial border of the cuboid
6. A "fleck" sign on the AP view, or an avulsion off the base of the of the
second metatarsal or medial cuneiform is a sign of a Lisfranc
ligament* injury
7. CT and/or MRI have been advantageous in radiographically subtle
Lisfranc injuries
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Lisfranc Fracture
Author: Russell Jones, MD