"homolateral: a homolateral injury is a lateral displacement of the 1st to 5th metatarsals or of 2nd to 5th metatarsals where the 1st TMT joint remains congruent"
"The key finding is malalignment of the second tarsometatarsal joint, such as lateral displacement of the second metatarsal base on AP view and/or dorsal step-off sign on lateral view 10. An additional abnormality is diastasis >2 mm between the 1st and 2nd metatarsal bases, although this should ideally be compared to the contralateral side 10. Weight-bearing views increase sensitivity for detecting subtle diastasis."
"The indication for operative management is an unstable injury. These can be divided into joint saving or joint sacrificing. Joint-saving surgery includes temporary fixation whilst awaiting definitive management and an ORIF. Joint-sacrificing surgery is either arthrodesis of the 1st, 2nd and 3rd tarsometatarsal joints or midfoot arthrodesis 12,14."
Expected headings
"Anatomy"
"Subtypes"
"Plain radiograph/CT"
"Complications"
"There are several types of Lisfranc fracture-dislocation:"
"These injuries are well demonstrated on the standard views of the foot. Still, subtle injuries may be missed and require further imaging such as CT, MRI or radiographic stress views with forefoot abduction. CT is, however, favoured as it will also demonstrate unsuspected associated fractures."
"Associated fractures most often occur at the base of the second metatarsal, seen as the fleck sign. They may also be seen in the 3rd metatarsal, medial or intermediate cuneiform, or navicular bones."
"Treatment may be non-operative or operative, with the aim being to have a painless, plantigrade and stable foot 12."
"The indication for operative management is an unstable injury. These can be divided into joint saving or joint sacrificing. Joint-saving surgery includes temporary fixation whilst awaiting definitive management and an ORIF. Joint-sacrificing surgery is either arthrodesis of the 1st, 2nd and 3rd tarsometatarsal joints or midfoot arthrodesis 12,14."
"Other possible findings are malalignment between the lateral border of the base of the 1st metatarsal and the lateral border of the medial cuneiform; malalignment between the medial border of the base of the 4th metatarsal and the cuboid (on the oblique view); increased distance between the medial cuneiform and the 2nd metatarsal; and increased distance between the medial and intermediate cuneiforms (C2) 13."
"Other possible findings are malalignment between the lateral border of the base of the 1st metatarsal and the lateral border of the medial cuneiform; malalignment between the medial border of the base of the 4th metatarsal and the cuboid (on the oblique view); increased distance between the medial cuneiform and the 2nd metatarsal; and increased distance between the medial and intermediate cuneiforms (C2) 13."
"Other possible findings are malalignment between the lateral border of the base of the 1st metatarsal and the lateral border of the medial cuneiform; malalignment between the medial border of the base of the 4th metatarsal and the cuboid (on the oblique view); increased distance between the medial cuneiform and the 2nd metatarsal; and increased distance between the medial and intermediate cuneiforms (C2) 13."