DEX IOT DAY 4 TEST - MIDFOOT &
FOREFOOT EXAM (2026) QUESTIONS AND
(elaborated) WITH COMPLETE SOLUTIONS
Where is the lisfranc joint? - ANSWER-Spans the entire midfoot articulation with
the metatarsals
What is the keystone conformation? - ANSWER-Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
What does the lisfranc ligament connect? - ANSWER-Medial cuneiform to base of
2nd met
Three aspects of lisfranc ligament: - ANSWER-Dorsal, interosseous, plantar
What makes up the lisfranc complex? - ANSWER-1st and 2nd met & medial and
middle cuneiform
What type of injury typically causes instability and gapping between bones of
lisfranc complex? - ANSWER-Axial load
Which column of the foot has the most flexibility? - ANSWER-Lateral column
, What mechanisms of injury occur with lisfranc pathology? - ANSWER-Direct or
indirect, high energy or low energy
What constitutes a direct injury? - ANSWER-axial load with dorsal and plantar
forces
What constitutes an indirect injury? - ANSWER-Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
What is necessary to diagnose lisfranc injury? - ANSWER-Weightbearing x-ray
What is a fleck sign? - ANSWER-Avulsion fracture between 2nd met and medial
cuneiform
What type of lisfranc injuries do not require surgery? - ANSWER-Nondisplaced and
stable
Lisfranc stability relies on ____ anatomy, while displacement relies on _____
anatomy - ANSWER-Ligamentous, bony
What is a downside of fixing/fusing lisfranc injury with screws? - ANSWER-No
micromotion - they can break
What is a benefit of lisfranc ORIF with plates? - ANSWER-Plate fixation maintains
stability without violating the articular surface
FOREFOOT EXAM (2026) QUESTIONS AND
(elaborated) WITH COMPLETE SOLUTIONS
Where is the lisfranc joint? - ANSWER-Spans the entire midfoot articulation with
the metatarsals
What is the keystone conformation? - ANSWER-Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
What does the lisfranc ligament connect? - ANSWER-Medial cuneiform to base of
2nd met
Three aspects of lisfranc ligament: - ANSWER-Dorsal, interosseous, plantar
What makes up the lisfranc complex? - ANSWER-1st and 2nd met & medial and
middle cuneiform
What type of injury typically causes instability and gapping between bones of
lisfranc complex? - ANSWER-Axial load
Which column of the foot has the most flexibility? - ANSWER-Lateral column
, What mechanisms of injury occur with lisfranc pathology? - ANSWER-Direct or
indirect, high energy or low energy
What constitutes a direct injury? - ANSWER-axial load with dorsal and plantar
forces
What constitutes an indirect injury? - ANSWER-Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
What is necessary to diagnose lisfranc injury? - ANSWER-Weightbearing x-ray
What is a fleck sign? - ANSWER-Avulsion fracture between 2nd met and medial
cuneiform
What type of lisfranc injuries do not require surgery? - ANSWER-Nondisplaced and
stable
Lisfranc stability relies on ____ anatomy, while displacement relies on _____
anatomy - ANSWER-Ligamentous, bony
What is a downside of fixing/fusing lisfranc injury with screws? - ANSWER-No
micromotion - they can break
What is a benefit of lisfranc ORIF with plates? - ANSWER-Plate fixation maintains
stability without violating the articular surface
