Ankle and Foot 47 - Department of Radiology - University of ...

2280 VII Imaging of the Musculoskeletal System
A
B
C
E
D
Figure 47-87. Divergent Lisfranc dislocation in a 34-year-old who was the front passenger in a motor vehicle accident. Radiographs were
obtained in the emergency department. Anteroposterior (A) and oblique (B) views of the foot reveal lateral dislocation of the second through fifth
metatarsals. The white arrow points to a fragment fractured off the base of the second metatarsal. The black arrowhead points to the base of the
fourth metatarsal, which is not articulating with anything. C, The Lisfranc dislocation is less obvious on the lateral view, although the base of the
fourth metatarsal (black arrowhead) is not articulating with anything. A closed reduction was attempted at the bedside but was unsuccessful.
D and E, CT scans were obtained to aid in surgical planning. Straight axial (long-axis) (D) and coronal oblique (long-axis) (E) images through the
Lisfranc joint show that none of the metatarsals (II to V) is articulating properly with its respective tarsal bone. Cu, cuboid; N, navicular.
Ch047-A05375.indd 2280
9/9/2008 5:35:29 PM