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Tarsometatarsal Joints (Lisfranc)

articulationes tarsometatarsales

The tarsometatarsal joints form the Lisfranc joint complex, a transverse articulation across the midfoot anchored by the Lisfranc ligament between the medial cuneiform and second metatarsal base. The second metatarsal base locked in its cuneiform recess creates the inherently stable keystone of the transverse arch. Disruption of this complex from high-energy trauma produces the Lisfranc fracture-dislocation, while subtle injuries in athletes can be purely ligamentous with no radiographic fracture.

Region: Foot & Ankle

Clinical Relevance

Clinical Notes

The absence of an interosseous ligament between the first and second metatarsal bases means the Lisfranc ligament is the sole interosseous connection between the medial and intermediate columns — explaining why its disruption produces the characteristic diastasis. Weight-bearing radiographs are essential — a gap greater than 2 mm between the first and second metatarsal bases or between the first metatarsal and medial cuneiform diagnoses instability. Even purely ligamentous Lisfranc injuries require surgical stabilisation to prevent midfoot collapse.

Pathology

Common Injuries & Conditions

Lisfranc Injury

TMT joint complex disruption from high-energy or low-energy twisting trauma producing diastasis on weight-bearing radiographs requiring surgical fixation to prevent midfoot collapse.