MRI of injuries to the first interosseous cuneometatarsal (Lisfranc) ligament.

Authors

• P J Macmahon
• S Dheer
• S M Raikin
• I Elias
• W B Morrison
• E C Kavanagh
• A Zoga

Publication/Presentation Date

3-1-2009

Abstract

OBJECTIVE: The objective of this study was to assess the utility of MRI in diagnosing injury to the first interosseous cuneometatarsal (Lisfranc) ligament and to additionally determine the associated patterns of traumatic soft tissue and osseous injury.

MATERIALS AND METHODS: Fifteen patients (16 feet) who were referred for MRI evaluation of the Lisfranc ligament, and had operative exploration or examination under anesthesia, were included for analysis. Standard non-contrast MRI foot imaging was performed in all cases. Evaluation of the following components was performed: the dorsal and plantar bundles of the Lisfranc ligament, the plantar tarsal metatarsal ligaments, soft tissue edema and fluid, and bone marrow edema and fractures. Surgical reports were regarded as the reference standard in all cases.

RESULTS: Seven of 10 cases of grade 3 Lisfranc ligament injuries at surgery were correctly graded at MRI. No cases of surgically proven complete Lisfranc ligament tears (grade 3) were interpreted as normal at MRI. All Lisfranc ligament sprains (grade 2 or 3) at surgery were detected at MRI. Two of six cases reported as grade 1 injuries at MRI were normal at surgery. No cases of surgically proven normal or sprained Lisfranc ligaments were interpreted as grade 3 tears on MRI. Four of six of our cases of normal or sprained Lisfranc ligaments demonstrated fractures; while the minority of complete Lisfranc ligament tears (3/10) contained fractures.

CONCLUSION: MRI is reasonably accurate at detecting traumatic injury to the Lisfranc ligament. However, in clinically suspected cases of traumatic Lisfranc ligament injury, true positive rate for sprain is low.

Volume

38

Issue

3

First Page

255

Last Page

260

ISSN

0364-2348

Published In/Presented At

Macmahon, P. J., Dheer, S., Raikin, S. M., Elias, I., Morrison, W. B., Kavanagh, E. C., & Zoga, A. (2009). MRI of injuries to the first interosseous cuneometatarsal (Lisfranc) ligament. Skeletal radiology, 38(3), 255–260. https://doi.org/10.1007/s00256-008-0613-6

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

19048208

Department(s)

Administration and Leadership

Document Type

Article