The Lisfranc ligament extends from the medial cuneiform to the medial base of the second metatarsal, and is biomechanically the strongest and stiffest stabilizing ligament of the medial tarsometatarsal joint [98,99]. The Lisfranc ligament is composed of dorsal, plantar, and interosseous components (Fig. 45)
[100,101]. Injury to the Lisfranc ligament occurs after midfoot trauma, and is common in athletes . When radiographs show diastasis at the second tarso-metatarsal joint, MRI is unnecessary to diagnosis Lisfranc ligament injury . Radiographic findings are often subtle, however, and in this setting, MRI is useful in identifying Lisfranc ligament tears or partial tears (Fig. 46)
. Methods of repair include closed reduction with casting, or surgical stabilization, most commonly with either Kirschner wire or cortical screw fixation
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