Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete.
BACKGROUND
Midfoot sprains in athletes represent a spectrum of injuries to the Lisfranc ligament complex, from partial sprains with no displacement to complete tears with frank diastasis. Treatment of these injuries varies from the treatment of high-velocity injuries seen in nonathletes.


OBJECTIVE
We wanted to report the outcome of treatment in athletes with Lisfranc injuries classified according to our system.


METHODS
Retrospective cohort study.


METHODS
Weightbearing radiographs and bone scintigrams were used to diagnose midfoot sprains in 15 athletes who were treated surgically or nonoperatively according to the following classification: nonoperative management for stage I injuries (undisplaced) and anatomic reduction with fixation for stage II (diastasis with no arch height loss) and stage III (diastasis with arch height loss) injuries.


RESULTS
We achieved an excellent outcome in 93% of 15 athletes with midfoot sprains at an average follow-up of 27 months (range, 9 to 72).


CONCLUSIONS
Weightbearing radiographs and bone scintigrams are sensitive, reproducible, and relatively inexpensive methods of investigation of these injuries. Restoration and maintenance of the anatomic alignment of the Lisfranc joint is the key to appropriate treatment of injury to the midfoot.
Nunley
James A
JA
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Vertullo
Christopher J
CJ
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D001484:Baseball / Q000293:injuries; D005260:Female; D018409:Foot Injuries / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D033023:Foot Joints / Q000293:injuries*; D005538:Football / Q000293:injuries; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D012189:Retrospective Studies; D012420:Running / Q000293:injuries; D012916:Soccer / Q000293:injuries; D013180:Sprains and Strains / Q000145:classification / Q000175:diagnosis / Q000628:therapy