weight bearing x-rays for lisfranc joint injury instability fracture radedasia




  • Early diagnosis of Lisfranc instability is crucial to prevent premature OA in the mid foot.

  • Subtle instability patterns can be very difficult to identify on xrays. 

  • Plain radiographs may not effectively identify instability at the LisFranc Joint, especially on non-weight-bearing views.

  • Weight-bearing x-rays are important as they reveal subtle differences between injured and uninjured sides.

  • However, weight bearing may not be possible in the acute phase due to pain

Lisfranc instability on weight bearing x-rays can be assessed by examining:

  • The lateral displacement of the second metatarsal in relation to the intermediate cuneiform on weight bearing radiographs C2M2 alignment. Step off more than 3mm.
  • The distance between the medial cuneiform and the base of the second metatarsal on weight bearing radiographs C1M2 distance. Distance more than 2.1mm.

  • Comparison views of the contralateral foot are also very useful.

  • Do both non weight bearing and weight bearing.

  • Subtle instability and widening can be easier to recognize when there is a direct comparison with normal.

  • Weight-bearing radiographs provide greater reliability in diagnosing Lisfranc instability compared to non-weight-bearing views.

  • Early diagnosis is important to prevent premature OA developing in the mid foot

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