Anatomy of the Lisfranc Ligament

Abstract

Most authors agree that anatomic reduction is the key to optimal results in treatment of injuries of the Lisfranc joint; a few controversies remain. One controversy is the identification of the strongest ligament of the second metatarsal-medial cuneiform articulation-the critical ligament of the Lisfranc joint. The purpose of this study is to objectively quantify the cross-sectional area of each ligament of this crucial joint. Twenty cadaveric feet were dissected to isolate the second metatarsal-medial cuneiform articulation. The point of maximum thickness, height, and width of the dorsal, plantar, and interosseous ligaments were measured using handheld calipers at the second metatarsal attachment. The distribution failed to pass Mauchly's test of sphericity, so the Greenhouse-Geisser method was used to assess differences in the height and width to a P <or= .05 level of significance. There was a significant difference in the height, width, and area between all ligaments (P < .001). The interosseous ligament was the largest, with the greatest height, width, and cross-sectional area (P < .001). The dorsal ligament was the smallest, with the least height, width, and cross-sectional area (P < .001). Within the Lisfranc complex, the dorsal ligament is the smallest. The plantar ligament is twice as large as the dorsal ligament. The interosseous ligament is the largest. It is, on average, 4.5 times larger than the dorsal ligament and twice as large as the plantar ligament.

Morphological characteristics of the Lisfranc ligament

“…[12], and 7.68 ± 1.25 mm [15]. For the plantar ligament, the bundle thickness was 3.25 ± 0.97 mm [15]. Therefore, no consensus has been obtained, and there are differences from the results of the present study.…”

“…In previous studies of the Lisfranc ligament, it was reported that the fiber bundle length was 8.02 ± 1.5 mm [12], 9.17 ± 1.5 mm (6.6-10.95) [13], and 33.7 ± 0.8 mm (2. [12], and 7.68 ± 1.25 mm [15]. For the plantar ligament, the bundle thickness was 3.25 ± 0.97 mm [15].…”

“…There is also large variation among reports on fiber bundle length, ranging from 8.02 mm to 33.7 mm [12][13][14]. The fiber bundle width was 2.53-12.5 mm [12][13][14], and bundle thickness was 5.4-7.68 mm [12][13][14][15]. The plantar ligament runs from the plantar surface of the first cuneiform to the M2 and the third metatarsal (M3).…”

The Midfoot Sprain: A Review of Lisfranc Ligament Injuries

“…[11][12][13][14][15][16][17][18][19] The dorsal ligaments are the weakest in the complex and are the first to fail in the typical indirect injury mechanism associated with subtle Lisfranc injuries. [11][12][13][14][15][16][17][18][19] The dorsal ligaments are the weakest in the complex and are the first to fail in the typical indirect injury mechanism associated with subtle Lisfranc injuries.…”

Akute Sportverletzungen und chronische Überlastungsschäden an Vor- und Mittelfuß

“…Abb. 12) zwischen Os cuneiforme mediale (Cm) und MT II besonders stabilisiert [25] [26]. Die Diagnostik schwerer Luxationsfrakturen stellt röntgenologisch keine besondere Herausforderung dar.…”