[Do not overlook Lisfranc injuries]

Lisfranc injury is rare and often very subtle. Subsequently, 20-50% of injuries are initially missed. Late or missed diagnosis increases the risk of post-traumatic osteoarthritis.

A 51-year old men visited our surgical outpatient clinic with plantar hematoma and inability to bear weight on the right foot after he tripped three weeks earlier. Initial visitation to the emergency department after trauma led to the diagnosis contusion or ligament injury of the foot/ankle. After additional CT-scan of the foot, the final diagnosis of subtle/stable Lisfranc injury was made. Twelve weeks after trauma, the patient still experienced pain and was dissatisfied with the course of treatment.

Timely diagnosis of Lisfranc injury is important to ensure adequate treatment may take place immediately. This achieves the most optimal prognosis. Always think of Lisfranc joint injury in case of plantar hematoma together with an inability to bear weight of the foot.