Intercuneiform dislocation is an important consideration in the initial treatment of fracture dislocations of the tarsometatarsal joint. The cuneiforms form a mortise for the second metatarsal which is the keystone of the tarsometatarsal articulations. The position of the second cuneiform is crucial to the integrity of the transverse arch of the foot. Proper initial treatment of these fractures includes precise reduction and stable fixation via open or closed methods so that the second metatarsal is restored as the tenon within a solid mortise formed by the cuneiforms.