Lisfranc Fracture-dislocation With Extensor Hallucis Brevis Tendon Interposition: A Case Report

A 14-year-old adolescent girl sustained a Lisfranc fracture-dislocation with an interposed extensor hallucis brevis (EHB) tendon. Following multiple failed attempts at closed reduction in both the emergency department and the operating room, the patient was treated in a staged manner with temporizing closed reduction and percutaneous pinning in improved alignment, followed by definitive open reduction and internal fixation once soft tissues allowed.

Anatomic reduction and stable fixation of Lisfranc injuries is vital to regain stability and reduce the risk of midfoot arthritis and collapse. To our knowledge, this is the only case report describing the EHB tendon as a block to reduction of a Lisfranc fracture-dislocation.