Case Study: Restoring Midfoot Stability and Function: Use of Lisfranc Stabilization Bridge Plate in Managing Midfoot Fractures and Ligamentous Instability of the First Through Third Tarsometatarsal (TMT) Joints – Christopher Diefenbach, MD

Patient History: A 21-year-old healthy active male sustained numerous midfoot avulsion fractures of the first through third tarsometatarsal (TMT) joints. The patient was initially evaluated in the emergency department after landing awkwardly on the extremity at a trampoline park. He landed on the foot in a plantarflexed position, rolling the dorsal foot underneath himself. He underwent splinting at that time with advanced demonstrated avulsion fractures and instability of the first through third tarsometatarsal joints. The patient then maintained non-weight bearing, elevation, and icing in a splint until the soft tissues allowed for surgical intervention. The patient was subsequently seen in the outpatient orthopedic clinic with transition into a cam walker boot while remaining non-weight bearing. This allowed evaluation of soft tissues which became amenable to surgical intervention three weeks following injury. The plan for open reduction and internal fixation with bridge plating was then discussed with the patient and his consent was obtained.