WEIGHT BEARING X-RAYS FOR LISFRANC JOINT INJURY INSTABILITY & FRACTURE (VIDEO)

WEIGHT BEARING X-RAYS FOR LISFRANC JOINT INJURY INSTABILITY & FRACTURE

• Early diagnosis of Lisfranc instability is crucial to prevent premature OA in the mid foot.
  
  
• Subtle instability patterns can be very difficult to identify on xrays. 
  
  
• Plain radiographs may not effectively identify instability at the LisFranc Joint, especially on non-weight-bearing views.
  
  
• Weight-bearing x-rays are important as they reveal subtle differences between injured and uninjured sides.
  
  
• However, weight bearing may not be possible in the acute phase due to pain

Lisfranc instability on weight bearing x-rays can be assessed by examining:
 

• The lateral displacement of the second metatarsal in relation to the intermediate cuneiform on weight bearing radiographs C2M2 alignment. Step off more than 3mm.
   
• The distance between the medial cuneiform and the base of the second metatarsal on weight bearing radiographs C1M2 distance. Distance more than 2.1mm.

• Comparison views of the contralateral foot are also very useful.
  
  
• Do both non weight bearing and weight bearing.
  
  
• Subtle instability and widening can be easier to recognize when there is a direct comparison with normal.

• Weight-bearing radiographs provide greater reliability in diagnosing Lisfranc instability compared to non-weight-bearing views.
  
  
• Early diagnosis is important to prevent premature OA developing in the mid foot