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A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. [1] [2]The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.
Lisfranc fracture, with an increased distance between the medial cuneiform and the second metatarsal. The Lisfranc ligament connects the medial cuneiform bone to the second metatarsal. [2] It is a complex of 3 ligaments: the dorsal Lisfranc ligament, the interosseous Lisfranc ligament, and the plantar Lisfranc ligament. [2] [3]
In runners, march fracture occurs most often in the metatarsal neck, while in dancers it occurs in the proximal shaft. In ballet dancers, fracture mostly occurs at the base of the second metatarsal and at Lisfranc joints. This fracture always occurs following a prolonged stress or weight bearing, and the history of direct trauma is very rare.
The synovial membrane between the second and third cuneiforms behind, and the second and third metatarsal bones in front, is part of the great tarsal synovial membrane. Two prolongations are sent forward from it, one between the adjacent sides of the second and third, and another between those of the third and fourth metatarsal bones.
These fractures are sometimes called march fractures, based on their traditional association with military recruits after long marches. The second and third metatarsals are fixed while walking, thus these metatarsals are common sites of injury. The fifth metatarsal may be fractured if the foot is oversupinated during locomotion. [9]
Practical Fracture Treatment 5th edition, page 187. Elsevier Health Sciences, 2008. ISBN 978-0-443-06876-8. Jefferson fracture: Sir Geoffrey Jefferson: fracture of first cervical vertebra: compression of neck: Jefferson fracture at Who Named It? Jones fracture: Sir Robert Jones: fracture of base of 5th metatarsal extending into intermetatarsal ...
Freiberg disease, also known as a Freiberg infraction, is a form of avascular necrosis in the metatarsal bone of the foot. It generally develops in the second metatarsal, but can occur in any metatarsal. Physical stress causes multiple tiny fractures where the middle of the metatarsal meets the growth plate.
Superior femoral neck stress fractures, if left untreated, can progress to become complete fractures with avascular necrosis, and should also be managed surgically. [13] Proximal metadiaphyseal fractures of the fifth metatarsal (middle of the outside edge of the foot) are also notorious for poor bone healing. [13]