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Closed Distal Dislocation of the Intermediate Cuneiform in a Complex Lisfranc Fracture-Dislocation

A Case Report

Asuma, Matti P. MD; CPT1; Mansfield, Taylor D. MD; CPT1; Turner, Eric K. MD; MAJ1; Robbins, Justin MD; LTC1

doi: 10.2106/JBJS.CC.18.00332
Case Reports

Case: A 21-year-old, active duty male sustained an irreducible, complex Lisfranc fracture-dislocation with distal extrusion of his intermediate cuneiform. He was treated in a staged manner with external fixator placement, followed by an extended midfoot fusion with autograft bone. At 19 months, he could perform all activities of daily living independently with minimal pain using an Intrepid Dynamic Exoskeletal Orthosis.

Conclusions: Complex Lisfranc injuries are severe and often result in chronic pain and disability after operative management. To our knowledge, this is the only case report describing a Lisfranc fracture-dislocation with a distally extruded intermediate cuneiform treated with a fusion.

1Orthopaedic Surgery Service, Madigan Army Medical Center, Tacoma, Washington

E-mail address for CPT M.P. Asuma: or

Investigation performed at Madigan Army Medical Center, Joint Base Lewis McChord, Washington

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
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