• Kevin D Anderson, Hollan Harper, and Sarah K Ayers.
• 37th Bomb Squadron, Air Force Base, SD 57706, USA.
• Mil Med. 2024 Jul 5.

AbstractThe tarsometatarsal joint, or Lisfranc joint, is an extremely important anatomical structure and injury to it has been shown to cause long-term disabling ramifications. With a wide spectrum of injury involvement, from fracture dislocations to sprains, it is important to establish a diagnosis early to guide management. Although the more extreme higher energy fracture dislocations are more widely studied, there remains a paucity of literature on lower energy purely ligamentous injuries, especially among military service members.1 The deployed setting provides an extra layer of complexity in determining a musculoskeletal injury etiology for the provider, especially in resource-limited areas. When a high level of suspicion for Lisfranc injury exists based upon clinical presentation and in the setting of negative X-rays, more prudence should be placed on additional workup. This will guide decision-making for possible expedited stateside return for the patient and better odds of follow-up care. The following case demonstrates a unique scenario of an undiagnosed, purely ligamentous Lisfranc tear in a 23-year-old woman in a deployed environment with late presentation to an orthopedic surgeon stateside. Furthermore, emphasis is placed on factors that led to her delayed diagnosis and how advocating for advanced imaging modalities up-front can expedite care.© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.

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