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DEX IOT DAY 4 TEST 2025 | MIDFOOT & FOREFOOT |
ALL QUESTIONS AND CORRECT ANSWERS | ALREADY
GRADED A+ | LATEST VERSION
Where is the lisfranc joint? - (answers)Spans the entire midfoot articulation with
the metatarsals
What is the keystone conformation? - (answers)Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
What does the lisfranc ligament connect? - (answers)Medial cuneiform to base of
2nd met
Three aspects of lisfranc ligament: - (answers)Dorsal, interosseous, plantar
What makes up the lisfranc complex? - (answers)1st and 2nd met & medial and
middle cuneiform
What type of injury typically causes instability and gapping between bones of
lisfranc complex? - (answers)Axial load
Which column of the foot has the most flexibility? - (answers)Lateral column
What mechanisms of injury occur with lisfranc pathology? - (answers)Direct or
indirect, high energy or low energy
What constitutes a direct injury? - (answers)axial load with dorsal and plantar
forces
What constitutes an indirect injury? - (answers)Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
What is necessary to diagnose lisfranc injury? - (answers)Weightbearing x-ray
What is a fleck sign? - (answers)Avulsion fracture between 2nd met and medial
cuneiform
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What type of lisfranc injuries do not require surgery? - (answers)Nondisplaced
and stable
Lisfranc stability relies on ____ anatomy, while displacement relies on _____
anatomy - (answers)Ligamentous, bony
What is a downside of fixing/fusing lisfranc injury with screws? - (answers)No
micromotion - they can break
What is a benefit of lisfranc ORIF with plates? - (answers)Plate fixation maintains
stability without violating the articular surface
What is ligamentous lisfranc augmentation (mini tightrope, internal brace)
typically indicated for? - (answers)Low energy injuries, mostly young adults and
highly active individuals
What is the gold standard for lisfranc injury fixation? - (answers)Plates and screws
What % of all fractures are lisfranc injuries? - (answers)0.2%
Who treats most lisfranc injuries? - (answers)Sports surgeons
What is the role of hardware in ORIF? - (answers)Maintains reduction, hardware
eventually removed
Role of hardware in fusion? - (answers)Compresses fusion, hardware left in place
What are lisfranc (diamond) plates indicated for? - (answers)Fixation or fusion;
high or low energy injuries; orientations left and right; sizes S,M,L; oblong
compression hole across lisfranc joint placed on 2nd met, other holes take 3.5
Lisfranc Internal Brace: - (answers)Purely ligamentous injuries, ideal for athletes;
cons: difficult to tension properly, can be difficult for soft bone; benefits: low-
profile fixation, strong biomechanical data (multi-plane fixation)
Knotless Mini Tightrope: - (answers)Purely ligamentous injuries, ideal for athletes;
alternative for those that struggle with IB; cons: medial button prominence;
DEX IOT DAY 4 TEST 2025 | MIDFOOT & FOREFOOT |
ALL QUESTIONS AND CORRECT ANSWERS | ALREADY
GRADED A+ | LATEST VERSION
Where is the lisfranc joint? - (answers)Spans the entire midfoot articulation with
the metatarsals
What is the keystone conformation? - (answers)Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
What does the lisfranc ligament connect? - (answers)Medial cuneiform to base of
2nd met
Three aspects of lisfranc ligament: - (answers)Dorsal, interosseous, plantar
What makes up the lisfranc complex? - (answers)1st and 2nd met & medial and
middle cuneiform
What type of injury typically causes instability and gapping between bones of
lisfranc complex? - (answers)Axial load
Which column of the foot has the most flexibility? - (answers)Lateral column
What mechanisms of injury occur with lisfranc pathology? - (answers)Direct or
indirect, high energy or low energy
What constitutes a direct injury? - (answers)axial load with dorsal and plantar
forces
What constitutes an indirect injury? - (answers)Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
What is necessary to diagnose lisfranc injury? - (answers)Weightbearing x-ray
What is a fleck sign? - (answers)Avulsion fracture between 2nd met and medial
cuneiform
, 2|Page
What type of lisfranc injuries do not require surgery? - (answers)Nondisplaced
and stable
Lisfranc stability relies on ____ anatomy, while displacement relies on _____
anatomy - (answers)Ligamentous, bony
What is a downside of fixing/fusing lisfranc injury with screws? - (answers)No
micromotion - they can break
What is a benefit of lisfranc ORIF with plates? - (answers)Plate fixation maintains
stability without violating the articular surface
What is ligamentous lisfranc augmentation (mini tightrope, internal brace)
typically indicated for? - (answers)Low energy injuries, mostly young adults and
highly active individuals
What is the gold standard for lisfranc injury fixation? - (answers)Plates and screws
What % of all fractures are lisfranc injuries? - (answers)0.2%
Who treats most lisfranc injuries? - (answers)Sports surgeons
What is the role of hardware in ORIF? - (answers)Maintains reduction, hardware
eventually removed
Role of hardware in fusion? - (answers)Compresses fusion, hardware left in place
What are lisfranc (diamond) plates indicated for? - (answers)Fixation or fusion;
high or low energy injuries; orientations left and right; sizes S,M,L; oblong
compression hole across lisfranc joint placed on 2nd met, other holes take 3.5
Lisfranc Internal Brace: - (answers)Purely ligamentous injuries, ideal for athletes;
cons: difficult to tension properly, can be difficult for soft bone; benefits: low-
profile fixation, strong biomechanical data (multi-plane fixation)
Knotless Mini Tightrope: - (answers)Purely ligamentous injuries, ideal for athletes;
alternative for those that struggle with IB; cons: medial button prominence;
