But when load is applied perpendicular to the injury, fatigue and failure of the fracture-dislocation site is common. When load is aligned with the direction of a fracture, the load can be distributed over a larger surface area. The load applied to the foot by the soleus muscle to limit forward motion during walking is applied to Lisfranc’s joint perpendicular to the injury. In the patient who has sustained a Lisfranc fracture-dislocation, simple weight bearing is a load applied to the injury site in a perpendicular manner. As our center of gravity moves forward, there is increasing and significant load applied to the midfoot and forefoot. The soleus muscle of the calf is designed to slowly limit range of motion at the ankle during walking. The function of the leg, ankle and foot is to act as a lever to manage that forward fall in a controlled manner. To move forward in walking, we shift our center of gravity forward and begin a forward fall. Walking can be described as a controlled forward fall. (3) Return to weight bearing and ambulation post Lisfranc fracture-dislocation Long term post traumatic arthritis is common in these cases and directly correlates to the success of anatomical reduction achieved at the time of surgery. Many patients who sustain these injuries are unable to return to their prior occupations and recreational activities. Lisfranc fracture-dislocations can be devastating injuries with lifelong disability. (1,2) Unfortunately, these classifications do not dictate the long term outcomes of theses fractures and dislocations. Lisfranc injuries are defined by classic fracture patterns including the Quenu and Kuss classification and the Hardcastle classification. These unique fractures and dislocations continue to bear his name to this date. Martin (1790-1847) was a French surgeon and gynecologist (a Jacques of all trades) who recognized this injury while treating soldiers of the Napoleonic Wars. When the trauma is specific to the tarsal-metatarsal joint, we call these injuries Lisfranc dislocations or Lisfranc fractures. ATV and motor sports injuries are common and often result in midfoot injuries. Working in a rural hospital I see a lot of foot and ankle trauma. Lisfranc fracture-dislocation benefits from Carbon Fiber Insoles
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