US Army-Baylor University Post Professional Sports Medicine-Physical Therapy Doctoral Residency, West Point, New York.
US Army-Baylor University Post Professional Sports Medicine-Physical Therapy Doctoral Residency, West Point, New York ; Regis University Orthopedic Manual Physical Therapy Fellowship, Denver, Colorado.
Sports Health. 2013 May;5(3):281-5. doi: 10.1177/1941738113477991.
Lisfranc joint injuries are fairly uncommon; however, few injuries hold such an elevated potential for devastating chronic secondary pain and disability. It is imperative when evaluating an injury to the ankle or foot to have a high clinical index of suspicion for Lisfranc injury, as physical examination findings are often subtle.
An 18-year-old military cadet reported to a direct-access sports physical therapy clinic with foot pain. Despite negative radiographic findings, there was a high suspicion for Lisfranc injury based on the injury mechanism and physical examination. A computed tomography scan demonstrated an oblique fracture through the base of the third metatarsal, a small marginal fracture at the plantar base of the second metatarsal, and a subtle diastasis. Two days following his injury, he underwent an open reduction and internal fixation, completed subsequent rehabilitation, and returned to full activity approximately 1 year following injury.
Early diagnosis of Lisfranc injuries is imperative for proper management and prevention of a poor functional outcome. If a strong clinical suspicion exists, negative radiographic findings are insufficient to rule out a Lisfranc injury, and therefore, advanced imaging is required.
跖跗关节损伤较为少见；然而，少数损伤却存在着引发慢性继发性疼痛和残疾的高风险。在评估踝关节或足部损伤时，对于跖跗关节损伤必须保持高度的临床怀疑指数，因为体格检查结果往往不明显。
一名 18 岁的军校学员因足部疼痛到直接就诊的运动物理治疗诊所就诊。尽管影像学检查未见异常，但根据损伤机制和体格检查，高度怀疑存在跖跗关节损伤。计算机断层扫描显示第三跖骨基底部斜形骨折，第二跖骨足底基底部有小的边缘骨折，以及轻微的分离。损伤后两天，他接受了切开复位内固定术，完成了随后的康复治疗，大约在受伤后 1 年恢复了完全活动。
早期诊断跖跗关节损伤对于正确治疗和预防不良功能结果至关重要。如果存在强烈的临床怀疑，影像学检查未见异常不足以排除跖跗关节损伤，因此需要进行高级影像学检查。
