This is a rare but serious injury to the mid foot joint between the tarsal bones and the metatarsal bases. There is a spectrum of injury from a mild sprain to a devastating fracture dislocation. The original name comes from a Napoleonic surgeon who described an amputation for the most severe variants of this injury! The joint is commonly sprained when a direct blow or load is applied to the foot when in a tiptoe position. This can occur as a result of a collision in contact sports, or due to a bad landing from a jump. Fracture dislocations of the joint can occur in road traffic accidents and can be very serious. The lisfranc ligament can get injured which allows some of the joints in the foot to move apart and can lead to collapse of the arch of the foot.
There is a range of symptoms from mild to severe, but in most cases there will be pain in the middle part of the foot which will be worse with walking. The foot may become quite swollen, and there can be bruising on the sole of the foot. Pulling the foot into a tiptoe position may make the pain worse.
If you think you have this condition it is well worth getting it checked as soon as possible by Mr Willis-Owen. You should avoid any aggravating activities with may make things worse. It will not get better on its own, and needs to be treated properly as soon as possible. If you try to ignore it, it may have serious long term effects.
Treatment involves first confirming the diagnosis which is not particularly easy. X-rays with you standing are helpful but MRI scanning or bone scanning is more helpful. Treatment ranges from plaster casts, minimally invasive surgery or open surgery depending on how unstable the foot is. It is an injury that is best dealt with early or, but unfortunately it is often missed but a non-expert. Salvage procedures for missed injuries may involve fusing the joint.