Percutaneous Reduction and Internal Fixation of the Lisfranc Fracture-Dislocation

  • Anish R. Kadakia
  • Mark S. MyersonEmail author


The success of minimally invasive percutaneous reduction and fixation of tarsometatarsal or Lisfranc injuries lies in understanding the appropriate injury pattern for this method of treatment. The eponym Lisfranc dislocation is derived from injuries sustained to cavalry troops in the Napoleonic era. These were associated with significant vascular and soft tissue injury, as they were treated with an amputation through the tarsometatarsal joints by Lisfranc, Napoleon’s surgeon. Although the injuries secondary to equestrian activity have declined, the injury pattern is commonly associated with high-energy motor vehicle accidents, falls, and crushing injuries to the foot.1–4 These mechanisms typically involve significant bony and soft tissue injury that rarely can be managed by closed methods (Fig. 42.1). Percutaneous fixation is most amenable in those patients with low-energy mechanisms, particularly in the athletic and elderly populations involving primarily a ligamentous injury (Fig. 42.2).


Soft Tissue Injury Injury Pattern Medial Border Percutaneous Fixation Medial Cuneiform 
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  1. 1.
    Myerson M. Tarsometatarsal arthrodesis: technique and results of treatment after injury. Foot Ankle Clin 1996;1:73–83.Google Scholar
  2. 2.
    Hardcastle P, Reschauer R, Kutscha-Lissberg E, Schoffmann W. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone Joint Surg Br 1982;64B(3):349–56.Google Scholar
  3. 3.
    Myerson M, Fisher R, Burgess A, Kenzora J. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 1986;6(5):225–42.PubMedGoogle Scholar
  4. 4.
    Gossens M, De Stoop N. Lisfranc fracture dislocations: etiology, radiology, and results of treatment. A review of 20 cases. Clin Orthop Relat Res 1983;176:154–62.Google Scholar
  5. 5.
    Curtis M, Myerson M, Szura B. Tarsometatarsal joint injuries in the athlete. Am J Sports Med 1993;21:497–502.CrossRefPubMedGoogle Scholar
  6. 6.
    Chiodo C, Myerson M. Developments and advances in the diagnosis and treatment of injuries to the tarsometatarsal joint. Orthop Clin North Am 2001;32(1):11–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Buzzard B, Briggs P. Surgical management of acute tarsometatarsal fracture dislocation in the adult. Clin Orthop Relat Res 1998;353:125–33.CrossRefPubMedGoogle Scholar
  8. 8.
    Aronow M. Treatment of the missed Lisfranc injury. Foot Ankle Clin N Am 2006;11:127–42.CrossRefGoogle Scholar
  9. 9.
    Myerson M. The diagnosis and treatment of injuries to the Lisfranc joint complex. Orthop Clin North Am 1989;20:655–64.PubMedGoogle Scholar
  10. 10.
    Myerson M. The diagnosis and treatment of injury to the tarsometatarsal joint complex. J Bone Joint Surg (Br) 1999;81-B:756–63.CrossRefGoogle Scholar
  11. 11.
    Coss H, Manos R, Buoncristiani A, Mills W. Abduction stress AP weightbearing radiography of purely ligamentous injury in the tarsometatarsal joint. Foot Ankle Int 1998;19(8):537–41.PubMedGoogle Scholar
  12. 12.
    Stein R. Radiological aspects of the tarsometatarsal joints. Foot Ankle 1983;3:286–9.PubMedGoogle Scholar
  13. 13.
    Quenu E, Kuss G. Etude sur les luxations du metatarse. Reb Chir Paris 1909;39(281).Google Scholar
  14. 14.
    Komenda G, Myerson M, Biddinger K. Results of arthrodesis of the tarsometatarsal joints after traumatic injury. J Bone Joint Surg Am 1996;78:1665–76.PubMedGoogle Scholar
  15. 15.
    Ouzounian T, Shereff M. In vitro determination of midfoot motion. Foot Ankle 1989;10:140–6.PubMedGoogle Scholar
  16. 16.
    Nunley J, Vertullo C. Classification, investigation, and management of midfoot sprains. Lisfranc injuries in the athlete. Am J Sports Med 2002;30(6):871–8.PubMedGoogle Scholar
  17. 17.
    Ly T, Coetzee J. Treatment of the primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. J Bone Joint Surg Am 2006;88-A(3):514–20.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Foot and Ankle InstituteMercy Medical CenterBaltimoreUSA

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