Lisfranc Injury Classifications
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This is basic MR, maybe, maybe not so basic,
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but let's talk classification systems.
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And I'm going to go with the most basic one,
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which is the Quénu and Kuss classification
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classification from 1909, about when I was born.
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It's divided Lisfranc fracture
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displacements into three categories,
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homolateral, isolated, and divergent.
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So what do we mean by this?
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Well, homolateral is the most common.
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In other words, all five of the metatarsal
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bases all go in the same direction.
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And they usually go this away.
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Then we have what I call isolated injuries.
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This is the least common.
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It consists of displacement of
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perhaps one or two metatarsal bones.
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Usually, in my experience, it's the second
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and the third that may slide or slip a little bit,
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but not the others.
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Then you've got the divergent one,
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which is rather catastrophic looking.
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It involves subluxation or dislocation of
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the first metatarsal medially while the
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other metatarsal bones move laterally.
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So if we look at the columnar
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presentation, we've got three columns.
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A medial column, a middle column,
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and a lateral column in the divergent form.
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The middle column and lateral column
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go out, or stay where they are,
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and the medial column goes this way.
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So the separation here is very dramatic.
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This is a very simple diagnosis to make.
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There are other classification systems.
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There will be a story for another day,
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such as the Myerson classification system,
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and you can Google that at your leisure.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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