Lisfranc ligamentous complex

The Lisfranc's joint complex refers to the complex polyarticular system with an intricate anatomic configuration of skeletal and nonskeletal elements of the tarsometatarsal joints. The skeletal elements are composed of the tarsometatarsal, intertarsal, and intermetatarsal articular surfaces 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 nonskeletal elements (Lisfranc ligamentous complex) comprise the articular capsules, the various ligaments, the prolongations of the long plantar ligament (inferior calcaneocuboid ligament), and the tendons and expansions of the tibialis posterior, tibialis anterior, and peroneus longus, which all function to maintain the stability of the TMT joints

The Lisfranc ligamentous complex consists of three main ligamentous structures:

• 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 first cuneometatarsal interosseous ligament ("Lisfranc ligament proper"), iCn1-M2

• The second plantar tarsometatarsal ligament (“plantar Lisfranc’s ligament”): variable bundles between tarsus and the second and third metatarsal bases pC1-M2,3