Isolated injury of the second tarsometatarsal joint. A case report

Injuries to tarsometatarsal (Lisfranc) joints are subtle, potentially disabling, and are still often overlooked. This case report of a rare isolated second Lisfranc joint dislocation (LJD) in a 46-year-old woman illustrates the typically subtle roentgenographic findings. A careful scrutiny of the base of the second metatarsal bone, especially on the lateral roentgenogram, shows alignment with the middle cuneiform. On an oblique view of the foot, the fourth metatarsal base should be aligned to the medial edge of the cuboid. Closed reduction of LJD is often unsuccessful and, if achieved, is often unstable. Soft-tissue or chondral fragment interposition impedes reduction. Open reduction and internal fixation are recommended.