Lisfranc Injury

A Lisfranc injury involves the joints and/or the ligaments of the middle of the foot. The injury can result from a major accident or a simple slip and fall. Sometimes this injury can be mistaken for a “sprain,” and not obtaining treatment can sometimes lead to more significant problems. The degree of injury can range from mild to severe.

Symptoms and Clinical Presentation

​Common symptoms of a Lisfranc injury are swelling and pain on the top of the foot.  Bruising is common, and bruising on the bottom of the foot is a clue this injury has occurred.  The appearance of the foot may range from grossly distorted in severe injuries to a normal appearance with only pain in subtle injuries.

Cause (including risk factors)

​These injuries may be low-energy and result from a slip and fall. This frequently occurs during athletic injuries but can also occur from a misstep or even missing a stair and stumbling over the top of the foot. High-energy injuries occur from direct trauma, such as a car accident or fall from a height.​


​The midfoot area is comprised of the joints and ligaments in the middle of the foot. The bones in this area are held together by a specialized ligamentous and bony complex in which the bones key together like puzzle pieces to maintain the arch of the foot. When the ligaments and/or bones in this area are injured, they may shift out of place disrupting their normal relationship.


​The diagnosis of a Lisfranc injury is made from your symptoms, performing an exam, reviewing X-rays, and sometimes additional tests. Your doctor will examine the middle part of your foot to identify the location(s) of pain and perform specialized tests to check the stability of this area. X-rays may demonstrate broken and or shifted bones in the middle of the foot.  Sometimes X-rays wihile standing or with pressure applied in order to identify shifting of bones in the foot. MRI may be helpful to see if the ligaments in the foot are damaged. A CT scan can help determine the extent of the bone injury and is useful when planning surgery.

*Source:  American Orthopaedic Foot & Ankle Society®