The diagnosis and treatment of injury to the tarsometatarsal joint complex

Although the eponym 'Lisfranc dislocation' is still often used to describe injuries to the tarsometatarsal joints, the term is misleading. It probably originated from the time of Napoleon and relates to injury to the foot sustained in falling from a horse, accompanied by severe vascular damage which necessitated amputation, the only method of treatment used by Lisfranc, surgeon to the Emperor. Since then, the incidence of severe vascular complications associated with injuries to the tarsometatarsal joint has declined to the extent that the only circumstances under which circulatory compromise is treated is in the presence of a compartment syndrome. Injuries to the midfoot are best described as those affecting the tarsometatarsal joint complex (TMC) which includes all the bones and joints directly or indirectly involved in a tarsometatarsal fracture-dislocation, including the cuneiforms, cuboid, and navicular.