Lisfranc joint complex

The Lisfranc joint complex refers to the tarsometatarsal joint of the midfoot, specifically involving the junction between the first, second, and third metatarsal bases and the medial, intermediate, and lateral cuneiforms, as well as the cuboid. The most critical anatomical relationship is between the medial cuneiform and the base of the second metatarsal, which is stabilized by the Lisfranc ligamentous complex.

The term “Lisfranc joint complex” is prefered for some authors than the terme ‘Lisfranc joint (Tarsometatarsal joints in TA2)’, because this joint is made by an intricate anatomic configuration of skeletal and nonskeletal elements which all function to maintain the stability of the TMT joints:

The skeletal elements are composed of the tarsometatarsal, intertarsal, and intermetatarsal articular surfaces. 

The nonskeletal elements comprise:

• The articular capsules, 

• The various ligaments forming the Lisfranc ligamentous complex:

  • The dorsal tarsometatarsal ligament ("dorsal Lisfranc's ligament") between the medial cuneiform (C1) to the base of the second metatarsal (M2), weakest part of the complex. As there are more than nine dorsal tarsometatarsal ligaments with a lot of variation, we cannot say if the Dorsal Lisfranc's ligament is the first, second or third dorsal tarsometatarsal ligament. It's better to use the formula dCn1-M2.

  • The firstcuneometatarsal interosseous ligament ("Lisfranc ligament proper")

  • The second plantar tarsometatarsal ligament (“plantar Lisfranc’s ligament”): variable bundles between tarsus and the second and third metatarsal bases 

• The prolongations of the long plantar ligament (inferior calcaneocuboid ligament), and the tendons

• Expansions of the tibialis posterior, tibialis anterior, and peroneus longus