Metatarsal fractures / intertarsal injuries
Intertarsal instabilities can be addressed before the Lisfranc injury is fixed. Any instabilities can be compressed with the pointed reduction forceps and held with K-wires. Screws can then be placed transversely between cuneiforms.
Cuneiform or metatarsal base fractures may preclude the use of screws. In these cases, small low-profile plates can be used in the intertarsal area, or as bridge plates from the metatarsal shaft across the metatarsal base / TMT joints to the cuneiforms.