Effective detection and management of low-velocity Lisfranc injuries in the emergency setting: principles for a subtle and commonly missed entity.

ABSTRACT

OBJECTIVE: To improve the ability of primary care physicians to recognize the mechanisms and common presentations of low-velocity Lisfranc injuries (LFIs) and to impart an improved understanding of the role of imaging and principles of primary care in low-velocity LFIs. SOURCES OF INFORMATION A MEDLINE literature review was performed and the results were summarized, reviewing anatomy and mechanisms, clinical and imaging-based diagnoses, and management principles in the primary care setting. MAIN MESSAGE Low-velocity LFIs result from various mechanisms and can have very subtle findings on clinical examination and imaging. A high degree of suspicion and caution are warranted when managing this type of injury. CONCLUSION: Although potentially devastating if missed, if a few treatment principles for low-velocity LFIs are applied from the initial presentation onward, outcomes from this injury can be optimized.