Presentation of a Lisfranc Injury to a Chiropractic Clinic: A Case Report

Objective

The purpose of this report is to describe the presentation of a patient with a previously undiagnosed Lisfranc injury to a chiropractic practice.

Clinical Features

A 56-year-old woman presented to a chiropractic clinic with traumatic right midfoot pain 6 months after her injury. She previously jumped out of bed, landing with her ankle inverted and causing severe pain. Before visiting the chiropractor, she saw 2 orthopedists shortly after onset and was told the imaging was normal; medicine and exercises were prescribed. Chiropractic examination found swelling of her foot, loss of sensation, and reduced and painful ankle range of motion. Radiographs revealed widening of the Lisfranc joint with lateral offset of the base of the second metatarsal.

Intervention and Outcome

The patient was referred for orthopedic consultation and underwent fusion of the first and second tarsometatarsal joints and the Lisfranc joint. After surgery, she was able to walk indoors unaided and outside with a walker. She reported 13 months later that she was able to walk 3 miles pain-free without assistance.

Conclusion

A Lisfranc injury was correctly identified after a thorough examination and radiographs. This case exhibits the importance of chiropractic practitioners understanding and being able to diagnose this injury, which aids in early and accurate assessment with appropriate referral.