What is a Lisfranc Injury?

By Justin Delicato, PTA, Site Coordinator

 What is a Lisfranc Injury?

Quick answer, a Lisfranc injury occurs when the midfoot bones are broken or ligaments of the midfoot are torn.  The Lisfranc joint is the area of the foot where the metatarsals and tarsal bones connect. The Lisfranc ligament supports the Lisfranc joint. These injuries can vary in complexity and are oftentimes misdiagnosed for simple sprains. However, the midfoot (arch of the foot) plays a crucial role in functional stability and gait.


What is a Lisfranc Injury? Lisfranc injuries occur in the midfoot when the supporting structures (bones or ligaments) are damaged

Diagram of the anatomy of the foot.

What causes a Lisfranc Injury?

This injury occurs from a fall when the ankle suddenly twists. This can happen with a simple twist and fall on top of a foot that is pointing downward.  A direct blow to the mid-foot (during sports, car accidents, fall from a height, etc.) can injure this foot area.


There are three main types of Lisfranc injuries: sprains, fractures, and dislocations.

  • Sprains: Create instability of the midfoot, as the weakened ligament cannot adequately support the foot’s arch after an injury.
  • Fractures: Breaks can occur in the associated midfoot bones – tarsals and metatarsals.
  • Dislocations: The supporting midfoot bones may shift out of place.

Symptoms of Lisfranc Injuries

  • Tenderness at the site of injury/top of the foot.
  • Swelling.
  • Bruising in the midfoot
  • Inability to put weight on your foot

Diagnosing Lisfranc Injuries

In order the make the proper diagnosis for the injury, your physician may:

  • Take a thorough history.
  • Perform a physical exam.
  • Take x-rays (to determine fractures and position of the bones), sometimes standing.
  • MRI or CT Scan


There are two main approaches to treat a Lisfranc Injury:  Conservative (non-surgical) or Surgical.

  • Non-surgical treatment. These do not involve significant tears, fractures, or dislocations. A walker boot or cast (non-weight-bearing only) allows the injury to heal.
    • Rest
    • Ice
    • Immobilization
    • Elevation (lifting limb above height to decrease swelling).
  • Surgical treatment. Bones are realigned to encourage appropriate healing and functional ability.  Sometimes, an ORIF (open reduction internal fixation) must be performed. This operation uses hardware (plates, screws, etc.) to ensure the integrity of the repair.


Individuals with Lisfranc injuries may benefit from physical therapy services, as advised by their MD.  After proper healing, rehab efforts encourage foot mobility and strengthening required for everyday function and a possible return to sport.

Author: Justin Delicato, PTA, Site Coordinator

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