Three-Dimensional, Digital, and Gross Anatomy of the Lisfranc Ligament

Abstract

Anatomic descriptions of location, dimensions, and variability in the position and surface area of the ligament attachment sites and of orientation of the bundles provide information for future attempts at repair or reconstruction of the Lisfranc ligament.

Morphological characteristics of the Lisfranc ligament

“…The classification based on differences in the Lisfranc ligament and the plantar ligament was Type I-a in 15 feet (37.5%), Type I-b in 4 feet (10%), Type II-a in 12 feet (30%), Type II-b in 3 feet (7.5%), Type III-a in 3 feet (7.5%), Type III-b in one foot (2.5%), and Type IV in 2 feet (5%). Previous anatomical studies reported that the Lisfranc ligament has a single fiber bundle [9], two fiber bundles (single fiber bundle in 73%, two fiber bundles in 27%) [11], and four fiber bundles (17 cases of one, 45 cases of two, 14 cases of four) [10], that the plantar ligament has varied directionality, and it divides into three directions depending on ligament morphology: linear in 32 cases, Y-shaped in 32 cases, Vshaped in 8 cases, and unclassified in 2 cases [10]. Therefore, no consensus has been obtained, and there are differences from the results of the present study.…”

“…Therefore, the present study supported the previous study. Regarding total fiber bundle angle, in the biomechanical study using fresh-frozen cadavers, amputation of the Lisfranc ligament and the plantar ligament was necessary to cause instability of the Lisfranc joint (C1-M2 joint and second cuneiform-M2 joint) [11]. Therefore, both ligaments may stabilize the Lisfranc joint.…”

“…In anatomical studies, consistent findings have not been obtained for the morphological features of the Lisfranc ligament and the plantar ligament. There are reports that the Lisfranc ligament has a single fiber bundle [9], two fiber bindles [11], and four fiber bundles [10]. There is also large variation among reports on fiber bundle length, ranging from 8.02 mm to 33.7 mm [12][13][14].…”

Tip-of-the-Iceberg Fractures: Small Fractures That Mean Big Trouble

“…Instead, the Lisfranc ligament complex, which is composed of dorsal, interosseous, and plantar components, courses obliquely between the medial cuneiform and second and third metatarsal bases [7-10]. Because it is considered the thickest, strongest, and best visualized component on MR images, the interosseous component is referred to as the Lisfranc ligament proper [5,7,10].The most common mechanism of Lisfranc injury is an axial load through the joint while the foot is in rigid plantar flexion. This force drives the metatarsals dorsally and produces ligamentous disruption and fractures along the tarsometatarsal joints.…”

“…In addition, strong, bandlike transverse intermetatarsal ligaments are present between the second through fifth metatarsals; however, no ligament is present between the proximal aspects of the first and second metatarsals [3,[5][6][7]. Instead, the Lisfranc ligament complex, which is composed of dorsal, interosseous, and plantar components, courses obliquely between the medial cuneiform and second and third metatarsal bases [7][8][9][10]. Because it is considered the thickest, strongest, and best visualized component on MR images, the interosseous component is referred to as the Lisfranc ligament proper [5,7,10].…”