The Lisfranc ligament is a ligament which connects the superior, lateral surface of the mediale cuneiform to the superior, medial surface of the base of the second metatarsal. This connection maintains proper alignment between the metatarsal and the tarsal bones. In 20% of people there are two bands of this ligament (dorsal and plantar). It is injured or disrupted in the Lisfranc fracture. Trauma to the midfoot is caused by direct and indirect impact forces. Direct force involves an object landing on the surface on the foot while indirect force involves twisting of the foot, usually an impact to the heel while the foot in pointed down toward the ground. A mild form of this injury results in a widening of the gap between the first and second metatarsals. An extreme form of the a Lisfranc fracture causes a complete dislocation of the metatarsals from the tarsal bones. When the alignment of the midfoot is affected joint cartilage is quickly damaged.
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