Diagnosis and Management of Lisfranc Injuries and Metatarsal Fractures

Forefoot and midfoot injuries are relatively common and can lead to chronic disability, especially if they are not promptly diagnosed and appropriately treated. A focused history and physical examination must be coupled with a thorough review of imaging studies to identify the cor-rect diagnosis. Subtle radiographic changes can represent significant ligamentous Lisfranc injury. Midfoot swelling in the presence of plantar ecchymosis should be consid-ered to be a Lisfranc injury until proven otherwise. While most metatarsal fractures can be treated with some form of immobilization and protected weight-bearing, this ar-ticle will distinguish these more common injuries from those requiring surgical intervention. We will review rel-evant anatomy and biomechanics, mechanisms of inju-ry, clinical presentation, imaging studies, and diagnostic techniques and treatment