A Lisfranc's Fracture-Dislocation in a Collegiate Football Player

The Lisfranc's fracture-dislocation is an extremely serious injury that needs immediate recognition and treatment. In displaced fractures, swelling and deformity will be evident. But, often, because of spontaneous reduction, chronic midfoot pain and arthritis may result if the injury goes unrecognized. The tarsometatarsal joint, referred to as Lisfranc's joint, can be fractured and dislocated by direct or indirect forces. In football, one possible injury mechanism occurs when a foot that is planted on the ground receives an axial force applied to the heel as the forefoot is hyperextended. Using a classification system, the dislocation can be identified and treated in reference to the damage done. Treatment should consist of a thorough examination, including evaluation of the vascular supply. The athlete should be immobilized and transported properly, nonweight-bearing, for medical referral. Correct rehabilitation will allow the athlete to return to competition.