Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report

Abstract

The protocol of this study was reviewed and approved by the Institutional Review Board. The patient was placed in the supine position and the Esmarch tourniquet was placed above ankle level. We made a dorsomedial incision between the first and the second metatarsals. The medial dorsal cutaneous branch of the superficial peroneal nerve was identified and protected. This incision allows visualization, debridement, reduction, and stabilization of the Lisfranc joint. The Freer test suggested by us uses a Freer elevator (width 5 mm, A Lisfranc joint injury is defined as a bony or ligamentous injury which involves the tarsometatarsal joint of the midfoot. Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Most authors agree that fracture or dislocation of the Lisfranc joint causes midfoot instability, which requires surgical treatment involving open reduction and internal fixation. Before surgery, instability can be confirmed through weight bearing radiograph and abduction stress radiograph. When instability is unclear, tests such as magnetic resonance imaging may be Technical Report