The interosseous Lisfranc ligament is the deep, strongest component connecting the plantar medial cuneiform to the base of the second metatarsal within the joint — the true Lisfranc ligament.
The primary Lisfranc joint stabiliser. Must be restored anatomically for joint stability and is the structure producing the fleck sign when it avulses bone.
ORIF targets restoration of this ligament's function by anatomically reducing the medial cuneiform-second metatarsal relationship. Primary Lisfranc arthrodesis has shown superior outcomes to ORIF in athletes in some studies.
True Lisfranc ligament tear producing primary instability requiring anatomic ORIF screw fixation of the medial cuneiform-second metatarsal.
Medial Lisfranc arthrodesis for athletes showing faster return to sport and reduced reoperation compared to screw fixation.
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