This case shows laterally dislocated 2nd through 5th metatarsal bones relative to the tarsals and suggests a Lisfranc dislocation, named after Jacques Lisfranc, who, as a field surgeon in Napoleon’s army, described an innovative technique to amputate the forefoot of soldiers as a means to treat frostbite. Of the two basic types, our patient appears to have the Homolateral type, wherein all the metatarsals are dislocated to one side.

Further reading:
http://emedicine.medscape.com/article/1236228-overview

Observation

Clinical History: Pain, swelling, ankle and foot fractures

Technique: DX left foot (3 views)

Compared with prior study dated February 2, 2010 (21:03)

The presence of cast material obscures subtle bony detail, limiting the study. At least three well corticated osseous structures posterior to the talus are again seen, unchanged. Partly imaged fractures of the medial and lateral malleolus show no significant interval change and are described in detail in the accompanying ankle films. The mineralization of the visualized bony structures is well maintained. Soft tissue swelling around the ankle joint is again seen and appears unchanged. Compared to the pre-reduction film, a lateral displacement of the second through fifth metatarsals and possibly also of the first metatarsal in relation to the tarsal bones, is now more apparent.

Impression

INTERVAL PLACEMENT OF CAST. LATERAL DISPLACEMENT OF THE SECOND THROUGH FIFTH METATARSALS IN RELATION TO THE TARSAL BONES, AND PROBABLY OF THE FIRST METATARSAL IS NOW MORE APPARENT, SUGGESTIVE OF A LISFRANC DISLOCATION. FURTHER EVALUATION WITH MRI MAY BE OF BENEFIT. OTHERWISE STABLE STUDY OF THE LEFT FOOT.