Case Study: Open Reduction Internal Fixation of Lisfranc Fracture Dislocation and Primary Arthrodesis of Comminuted Second Metatarsal Base Fracture Using the ExtremiLock Lisfranc Dorsomedial Plate – Waldemar Majdanski, DPM, FACFAS

Case Presentation: A 35-year-old healthy male sustained a Lisfranc dislocation with a comminuted intra-articular second metatarsal base fracture. The patient tripped over a forklift and fell forward twisting the foot under his body. Radiographic imaging revealed diastasis between the lateral aspect of the medial cuneiform and the base of the second metatarsal, with a large fleck sign present. Patient was seen and referred for a CT scan to evaluate for the extent of articular involvement. The CT scan revealed a comminuted intra-articular fracture at the base of the second metatarsal. Due to Lisfranc dislocation and an intra-articular fracture, a plan for open reduction and internal fixation with primary arthrodesis of the second tarsometatarsal joint (TMTJ), with possible bone grafting and use of anatomic Lisfranc plating, was then discussed with the patient and his consent was obtained.