Episode 76.0 – The Lisfranc Injury

This week we discuss Lisfranc injuries with a focus on a diagnostic pathway and management.

Take Home Points

  1. A Lisfranc injury is a midfoot injury that results in displacement of one or more of the metatarsal bones from tarsus. 
  2. XR will show widening of the space between the 1st and 2nd metatarsals. Getting contralateral XR may help you identify this.
  3. Even if you don’t see that widening on the XR, the patient could still have a Lisfranc injury. If they cannot walk due to pain, get a weight bearing XR or CT scan to look further.
  4. Once the injury is identified, the patient must be strict non-weightbearing. Place them in a posterior splint and get orthopedics involved either in the ED or for prompt follow up as the patient will probably need surgery.
Foot Bones (Google Images)

Foot Bones (Google Images)

Normal Foot X-ray Series (Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case rID: 36688)

Normal Foot X-ray Series (Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case rID: 36688)

Lisfranc Injury AP X-ray (Radiopaedia Image #1: Case courtesy of Dr Alexandra Stanislavsky, Radiopaedia.org. From the case rID: 10919)

Lisfranc Injury AP X-ray (Radiopaedia Image #1: Case courtesy of Dr Alexandra Stanislavsky, Radiopaedia.org. From the case rID: 10919)

Divergent Lisfranc Injury

Divergent Lisfranc Injury

Read More

LITFL: Eponymous Fractures

Radiopaedia: Lisfranc Injury

Core EM: Compartment Syndrome

Show Notes

Take Home Points

  1. A Lisfranc injury is a midfoot injury that results in displacement of one or more of the metatarsal bones from tarsus. 
  2. XR will show widening of the space between the 1st and 2nd metatarsals. Getting contralateral XR may help you identify this.
  3. Even if you don’t see that widening on the XR, the patient could still have a Lisfranc injury. If they cannot walk due to pain, get a weight bearing XR or CT scan to look further.
  4. Once the injury is identified, the patient must be strict non-weightbearing. Place them in a posterior splint and get orthopedics involved either in the ED or for prompt follow up as the patient will probably need surgery.
Foot Bones (Google Images)

Foot Bones (Google Images)

Normal Foot X-ray Series (Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case rID: 36688)

Normal Foot X-ray Series (Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case rID: 36688)

Lisfranc Injury AP X-ray (Radiopaedia Image #1: Case courtesy of Dr Alexandra Stanislavsky, Radiopaedia.org. From the case rID: 10919)

Lisfranc Injury AP X-ray (Radiopaedia Image #1: Case courtesy of Dr Alexandra Stanislavsky, Radiopaedia.org. From the case rID: 10919)

Divergent Lisfranc Injury

Divergent Lisfranc Injury

Read More

LITFL: Eponymous Fractures

Radiopaedia: Lisfranc Injury

Core EM: Compartment Syndrome

Read More

The post Episode 76.0 – The Lisfranc Injury appeared first on FOAM EM RSS.

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