Lisfranc Ligament Rupture

A Lisfranc ligament rupture is a serious injury involving the midfoot, often underdiagnosed or misdiagnosed, which can lead to chronic pain, deformity, and long-term functional impairment if not treated correctly.

At Perth Orthopaedic & Sports Medicine Centre, Dr Daniel Meyerkort offers comprehensive care for Lisfranc injuries, utilising both non-surgical and surgical options, including state-of-the-art fixation techniques such as the Arthrex Lisfranc Compression Plate (Diamond Plate).

What is a Lisfranc Ligament Rupture?

The Lisfranc ligament complex stabilises the midfoot, specifically the articulation between the medial cuneiform and the base of the second metatarsal. A rupture of this ligament can result from high-energy trauma, such as motor vehicle accidents or sporting injuries, or low-energy twisting mechanisms, often seen in athletes or during falls.

A Lisfranc injury may involve:

  • Ligamentous rupture alone

  • Fracture-dislocations of the tarsometatarsal joints

  • Combined ligament and bony injury

Symptoms and Diagnosis

Patients often report:

  • Midfoot pain and swelling

  • Inability to bear weight

  • Bruising on the sole of the foot (a hallmark sign)

  • Pain worsened with standing or walking

Clinical examination is complemented with imaging:

  • Weight-bearing X-rays may reveal diastasis or incongruity

  • MRI identifies soft tissue injury, particularly ligament disruption

  • CT scans assess for subtle fractures or displacement

Early and accurate diagnosis is key to optimal outcomes. At Perth Orthopaedic & Sports Medicine Centre, we provide advanced imaging access and expert assessment to avoid delayed or missed diagnoses.

Non-Surgical Management

Non-operative treatment may be appropriate in:

  • Non-displaced injuries

  • Isolated ligamentous injuries without instability

  • Low-demand patients

This involves:

  • Immobilisation in a non-weight-bearing cast or boot for 6–8 weeks

  • Gradual rehabilitation with physiotherapy focusing on mobility, strength, and gait training

Benefits of non-surgical management:

  • Avoids risks associated with surgery

  • Effective for stable, non-displaced injuries

  • Shorter recovery times in mild cases

Risks of non-surgical management:

  • Potential for missed instability

  • Risk of chronic midfoot pain or arthritis if alignment worsens

  • May require surgery later if symptoms persist

Surgical Management

Surgery is the gold standard for:

  • Displaced or unstable injuries

  • High-demand athletes

  • Combined fracture-dislocations

  • Chronic symptomatic Lisfranc injuries

At Perth Orthopaedic & Sports Medicine Centre, Dr Daniel Meyerkort specialises in modern fixation techniques tailored to the individual’s anatomy and injury severity.

Traditional Surgical Techniques

  • Open Reduction and Internal Fixation (ORIF): Utilises screws or plates to realign and stabilise the joint

  • Primary Arthrodesis: Fusion of the affected joints, preferred in purely ligamentous injuries with high risk of arthritis

These techniques remain effective but carry certain limitations, especially in terms of hardware irritation, loss of reduction, or joint stiffness.

The Arthrex Lisfranc Compression Plate (Diamond Plate) Technique

The Arthrex Lisfranc Compression Plate, commonly referred to as the Diamond Plate, is an innovative surgical solution offering several key advantages over traditional screw fixation.

Key Features of the Arthrex Diamond Plate:

  • Designed for anatomical fixation of the Lisfranc joint

  • Allows precise compression across the medial cuneiform and second metatarsal base

  • Low-profile titanium plate minimises soft tissue irritation

  • Can be combined with bridge plating for complex injuries

  • Facilitates early range of motion compared to conventional rigid screw fixation

Benefits of Arthrex Diamond Plate Fixation

  • Superior biomechanical stability: Offers better resistance to displacement during loading

  • Preserves joint anatomy: Unlike fusion, it retains the natural joint

  • Lower profile: Less risk of hardware-related discomfort

  • Faster rehabilitation potential: Allows for earlier weight-bearing in selected cases

  • Reduced risk of post-traumatic arthritis: By maintaining alignment and motion

Risks of the Diamond Plate Procedure

  • As with any surgery, risks include infection, nerve injury, DVT, and anaesthetic complications

  • Possibility of hardware irritation requiring removal

  • Non-union or malunion in complex fracture-dislocations

  • Post-operative stiffness or persistent pain in some cases

  • Requires technical precision – best performed by a fellowship-trained foot and ankle surgeon like Dr Meyerkort

Post-Operative Recovery

Following Arthrex plate fixation:

  • Non-weight bearing in a boot or cast for 6–8 weeks

  • Transition to partial weight-bearing under physiotherapist guidance

  • Progressive physiotherapy begins after radiographic signs of healing

  • Return to sports or high-level activity typically occurs at 4–6 months

Individual recovery varies depending on injury severity, patient age, and compliance with rehab protocols.

Why Choose Dr Daniel Meyerkort and Perth Orthopaedic & Sports Medicine Centre?

Dr Daniel Meyerkort is a highly experienced orthopaedic surgeon based in Perth, offering:

  • Fellowship training in sports ankle / foot injury

  • Access to advanced surgical technologies, including the Arthrex Lisfranc Diamond Plate system

  • A multidisciplinary team of physiotherapists and sports medicine specialists

  • Comprehensive care from diagnosis to rehabilitation

  • Telehealth options for regional patients across Western Australia

A Lisfranc ligament rupture is a serious injury that demands timely and appropriate management. Non-surgical treatment is effective for stable injuries, while unstable or displaced injuries benefit from surgical fixation. The Arthrex Diamond Plate offers a modern, biomechanically superior solution for restoring midfoot stability while preserving joint motion.

Under the expert care of Dr Daniel Meyerkort at Perth Orthopaedic & Sports Medicine Centre, patients can expect evidence-based treatment, personalised rehabilitation plans, and access to the latest surgical innovations.

Personalised Orthopaedic Care in Perth

If you suspect a Lisfranc injury or have ongoing foot pain following trauma, early intervention is crucial. Book a consultation with Dr Daniel Meyerkort today at Perth Orthopaedic & Sports Medicine Centre to discuss your options and ensure the best possible outcome.