Lisfranc's fracture-dislocation with intercuneiform dislocation: presentation of two cases an a plan for treatment.

The following guidelines in the initial treatment of Lisfranc's fracture-dislocation with intercuneiform disruption are supported by a review of the literature and exemplified by our case presentations. The goal of initial treatment is anatomical reduction which is accomplished in the following sequence. 1) The foot must be brought to length by longitudinal traction. 2) The position of the second cuneiform as the keystone of the transverse arch of the foot must be established. 3) The second metatarsal is then restored as the tendon of the Lisfranc's joint within the mortise of cuneiforms. 4) Fixation of the fifth metatarsal is performed if it is unstable.