What is the mechanism of injury commonly associated with a Lisfranc dislocation?

• A. Rotation with foot dorsiflexed
• B. Abduction with the foot in plantarflexion
• C. Direct trauma to the foot
• D. Sole compression during weight-bearing

Answer: (B)

A Lisfranc dislocation typically occurs due to an abduction force when the foot is in plantarflexion. This mechanism of injury is essential to understand because it highlights the vulnerable state of the Lisfranc joint complex, where the metatarsals articulate with the tarsal bones. When the foot is plantarflexed, the lever arm of the metatarsals increases, making them more susceptible to forces that can lead to dislocation or fracture.

This abduction mechanism involves lateral stress applied to the midfoot, resulting in a disruption of the ligaments and the alignment of the metatarsals. Such injury is common in sports involving sudden directional changes, falls, or high-impact impacts, effectively illustrating how specific positioning of the foot combined with an external force can lead to this type of injury.

While rotation or direct trauma can cause a variety of foot injuries, the unique positioning of the foot in plantarflexion during an abduction maneuver is key to the mechanism of a Lisfranc dislocation, distinguishing it from other types of injuries that may affect the foot. Similarly, sole compression during weight-bearing does not specifically target the Lisfranc area in the same manner as abduction with the foot in plantarflexion, making it