Six-Week Old Neglected Homolateral Lisfranc Injury - A Case Report

Lisfranc injury is relatively rare and is commonly missed at the initial presentation as these injuries are easily misdiagnosed as a foot sprain. We report a case of chronic foot pain following an injury which was later diagnosed to be a neglected 6 weeks old complex Lisfranc fracture dislocation.

A 53-year-old man presented with chronic foot pain and swelling which was diagnosed to be a neglected 6-week-old homolateral type of Lisfranc injury (type A Hard castle and Meyerson). We treated him with open reduction and internal fixation (ORIF) with plates and screws and achieved excellent functional outcome at 6-month follow-up period.

Lisfranc injuries are frequently undetected with estimates ranging from 20% to 80%. Anteroposterior, lateral, and medial oblique views of the foot should be included in the radiological workup following a thorough physical examination. Our case will aid the deficient literature and guide the young surgeons in management of such cases.

Given the history and nature of the injury, it can be easily missed by a beginner and the clinician must keep a high index of suspicion when treating these injuries in emergency department. To prevent the many complications linked to this kind of injury, it requires a correct diagnosis and timely treatment in the form of closed/open reduction and fixation. Delayed presentation of such cases can be treated with ORIF and good functional outcome can be achieved.