What is a Lisfranc ligament?

The Lisfranc ligament is a key stabilizer of the midfoot, extending from the lateral aspect of the medial cuneiform to the medial base of the second metatarsal.

Anatomically, it is an interosseous ligament with fibers running obliquely from posterolateral on the cuneiform to anteromedial on the second metatarsal base. Its proximal attachment is on the plantar aspect of the lateral cuneiform’s lateral surface, near the articulation with the first and second cuneiforms, while its distal attachment is on the plantar medial base of the second metatarsal.
It is enveloped by a surrounding capsule and ligamentous structures, with its primary blood supply originating from perforating branches of the dorsalis pedis and lateral plantar arteries. The nerve supply, mainly from the medial dorsal cutaneous nerve branch, provides proprioception vital for stability. Its robust, fibrous structure allows it to withstand significant axial and shear forces across the tarsometatarsal joint.
In surgical practice, understanding the precise oblique orientation, attachments, and surrounding neurovascular anatomy is critical for effective repair or reconstruction in Lisfranc injuries. Proper recognition ensures accurate fixation, restores stability, and optimizes functional outcomes.

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