Lisfranc injuries sustained during athletics may be subtle and may be associated with poor outcomes if inadequately identified and treated.
Accurate diagnosis may involve a combination of weight-bearing radiographs, weight-bearing computed tomography (CT), magnetic resonance imaging (MRI), and/or intraoperative stress examination to determine whether surgical fixation is necessary.
Nonoperative treatment may be indicated in certain cases that demonstrate radiographic stability with weight-bearing images. A period of non-weight-bearing leads to better outcomes with nonoperative treatment.
Operative fixation is associated with a high likelihood of full return to sport. Plate fixation may be superior to screw fixation with regard to reduction, risk of arthritis, and need for secondary arthrodesis.
Open reduction and internal fixation is a suitable treatment option for the Lisfranc injury in the athlete, although successful outcomes and return to athletics are also demonstrated after a primary arthrodesis.