Lisfranc Ligament

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)

Lisfranc Ligament Mri
Fig. 50. Axial (A) and sagittal (B) FSE images demonstrate complete rupture of the Achilles tendon. (Courtesy of Department of MRI, Hospital for Special Surgery, New York, NY.)
Lisfranc Ligament
Fig. 51. Sagittal FSE and STIR images demonstrate tendinosis of the distal Achilles tendon, fluid distention and thickening of the retrocalcaneal bursa, and superficial tendo-Achilles bursa.

[100,101]. Injury to the Lisfranc ligament occurs after midfoot trauma, and is common in athletes [98]. When radiographs show diastasis at the second tarso-metatarsal joint, MRI is unnecessary to diagnosis Lisfranc ligament injury [101]. Radiographic findings are often subtle, however, and in this setting, MRI is useful in identifying Lisfranc ligament tears or partial tears (Fig. 46)

[101]. Methods of repair include closed reduction with casting, or surgical stabilization, most commonly with either Kirschner wire or cortical screw fixation

Plantar Fasciitis Mri
Fig. 52. Sagittal FSE (A) and STIR (B) images demonstrate acute rupture of the plantar fascia (arrows) in a tennis player. (Courtesy of Department of MRI, Hospital for Special Surgery, New York, NY.)
Lisfranc Surgery Pictures
Fig. 53. Sagittal STIR (A) and FSE (B) images demonstrate increased signal intensity, thickening, and inhomogeneous appearance of the plantar fascia. Plantar fasciitis.

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