Lisfranc’s fracture-dislocation may be secondary to acute trauma, but on the basis of our experience with seven cases, it is more commonly a manifestation of repetitive subclinical trauma in patients with a neuropathic disorder. Separation of these two groups of patients is important, since those with acute trauma require reduction and those with a neuropathy need only be treated with non-weight bearing. All patients with Lisfranc’s fracture-dislocation and without a specific history of acute trauma should be evaluated for the possibility of diabetes mellitus or another cause of sensory neuropathy.