Lisfranc Fracture Symptoms and Treatment

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

When Napoleon led his army to disaster in the Russian winter, many of his soldiers suffered from frostbite and developed gangrene of the toes and feet. Dr. Jacques Lisfranc de St. Martin figured out the anatomy of the foot, and found that cutting through joint spaces made amputation easier. His legacy is that fractures, dislocations, and sprains that affect the junction between the upper and lower foot bones bear his name. Lisfranc injuries refer to damage to the joints where the long thin metatarsal bones of the foot meet the tarsal bones (the cuboid and cuneiforms) that make up the midfoot.

Lisfranc fractures often occur when a person steps in a hole and the toes become caught, and then the person falls forward. This torque causes the ligaments that hold the joints together to tear, the joint to become unstable, and the alignment of the bones to be lost. In car accidents or other major trauma injuries, not only can the ligaments be damaged, but when the bones break, the midfoot can dislocate. In football, the Lisfranc joint is damaged when the toe is pointed downward and another player falls on the exposed heel. Such was the fate that befell Matt Schaub of the Houston Texans in 2011, and Dwight Freeney of the Indianapolis Colts in 2007.