Which injury involves disruption of the tarsometatarsal joints leading to midfoot instability?

Which injury involves disruption of the tarsometatarsal joints leading to midfoot instability?

• A. Jones fracture
• B. Navicular fracture
• C. Chopart injury
• D. Lisfranc injury

Answer: (D)

Midfoot stability hinges on the tarsometatarsal joints, and disruption of these joints, especially along the Lisfranc ligament complex linking the medial cuneiform to the base of the second metatarsal, leads to midfoot instability. This pattern of injury is the Lisfranc injury, typically resulting from an axial load on a plantarflexed foot and presenting with midfoot pain, swelling, and sometimes plantar bruising; weight-bearing imaging may show misalignment between the metatarsal bases and the tarsal bones, with signs such as diastasis or a fleck sign on radiographs, and CT or MRI can help in uncertain cases. The other conditions involve different structures: a Jones fracture is at the base of the fifth metatarsal and does not involve the tarsometatarsal joints; a navicular fracture involves the navicular bone itself; a Chopart injury affects the talonavicular and calcaneo‑cuboid joints, not the tarsometatarsal joints.

Midfoot stability hinges on the tarsometatarsal joints, and disruption of these joints, especially along the Lisfranc ligament complex linking the medial cuneiform to the base of the second metatarsal, leads to midfoot instability. This pattern of injury is the Lisfranc injury, typically resulting from an axial load on a plantarflexed foot and presenting with midfoot pain, swelling, and sometimes plantar bruising; weight-bearing imaging may show misalignment between the metatarsal bases and the tarsal bones, with signs such as diastasis or a fleck sign on radiographs, and CT or MRI can help in uncertain cases. The other conditions involve different structures: a Jones fracture is at the base of the fifth metatarsal and does not involve the tarsometatarsal joints; a navicular fracture involves the navicular bone itself; a Chopart injury affects the talonavicular and calcaneo‑cuboid joints, not the tarsometatarsal joints.