Mechanism of the injury
Tarso-metatarsal (Lisfranc) injuries may be caused by direct or indirect forces.
Direct forces include a crush injury (MVA or industrial) or a direct blow. These may be combined with soft-tissue injury and present as open fractures.
Indirect injuries are more common. They result from an axial load to a plantarflexed foot. They may occur during sports, or stepping down from a stair or sidewalk.