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Rupture of Lisfranc's Ligament in Athletes*

Department of Orthopaedic Surgery, University of California, Los Angeles Medical Center, Los Angeles, California

Daniel C. Wascher, MD

Department of Orthopaedic Surgery, University of California, Los Angeles Medical Center, Los Angeles, California

Gerald A. M. Finerman, MD

Department of Orthopaedic Surgery, University of California, Los Angeles Medical Center, Los Angeles, California

Ligamentous injuries to the tarsometatarsal joints are uncommon and usually result from violent trauma to the forefoot. A more subtle tarsometatarsal injury consisting of an isolated diastasis of the first and second tarso metatarsal rays has recently been described. This injury is thought to be caused by a rupture of Lisfranc's liga ment. Nine injuries that occurred during athletics are described. History and physical findings are crucial for arousing the clinician's suspicion for this injury, but con firmation can best be obtained by comparison weight bearing radiographs; the space between the first and second metatarsal bases may be widened 2 to 5 mm. Nonoperative treatment consisting of casting and the use of crutches for 4 to 6 weeks was successful in re turning patients back to athletics; however, the time to return to competition averaged 4 months.

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