Lisfranc fracture-dislocations are uncommon injuries with several variations. We present one such variation and include a pertinent review of the literature. This case is unusual in that there was lateral tarsometatarsal disruption with neither diastasis between the first and second metatarsals nor injury to either the first or second tarsometatarsal joints. Destabilization of the lateral Lisfranc joints was secondary to fractures through the second and third metatarsal shafts. Anatomic reduction and stabilization of the lateral Lisfranc joints resulted only after open anatomic reduction and internal fixation of the metatarsal fractures. Two-year follow-up confirmed an excellent clinical and radiographic result.