Lisfranc Injuries When to Observe, Fix, or Fuse

Injuries to the foot are common in the athletic population, accounting for approximately 16% of sporting injuries. The bony and ligamentous structures around the first and second tarsometatarsal (TMT) joints, or Lisfranc joint complex, are the most commonly involved in injuries to the midfoot because of the limited static and dynamic stability of this region. The appropriate management of Lisfranc or TMT joint injuries in athletes is controversial, with multiple classification schemes and treatment methods and little evidence-based guidelines to deliver appropriate care. This article reviews the current diagnosis and management principles for TMT injuries in the athletic population.