DEX IOT DAY 4 TEST - MIDFOOT
& FOREFOOT 70+ QUESTIONS
AND ANSWERS WELL VERIFIED
AND GRADED
1. Where is the lisfranc joint?: Spans the entire midfoot articulation with the
metatarsals
2. What is the keystone conformation?: Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
3. What does the lisfranc ligament connect?: Medial cuneiform to base of 2nd
met
4. Three aspects of lisfranc ligament:: Dorsal, interosseous, plantar
5. What makes up the lisfranc complex?: 1st and 2nd met & medial and
middle cuneiform
6. What type of injury typically causes instability and gapping between
bones of lisfranc complex?: Axial load
7. Which column of the foot has the most flexibility?: Lateral column
8. What mechanisms of injury occur with lisfranc pathology?: Direct or
indirect, high energy or low energy
9. What constitutes a direct injury?: axial load with dorsal and plantar forces
10. What constitutes an indirect injury?: Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
1/7
, .
11. What is necessary to diagnose lisfranc injury?: Weightbearing x-ray
12. What is a fleck sign?: Avulsion fracture between 2nd met and medial
cuneiform 13. What type of lisfranc injuries do not require surgery?:
Nondisplaced and stable
14. Lisfranc stability relies on ____ anatomy, while displacement relies on
_____ anatomy: Ligamentous, bony
15. What is a downside of fixing/fusing lisfranc injury with screws?: No
micromotion - they can break
16. What is a benefit of lisfranc ORIF with plates?: Plate fixation maintains
stability without violating the articular surface
17. What is ligamentous lisfranc augmentation (mini tightrope, internal
brace) typically indicated for?: Low energy injuries, mostly young adults and
highly active individuals
18. What is the gold standard for lisfranc injury fixation?: Plates and screws
19. What % of all fractures are lisfranc injuries?: 0.2%
20. Who treats most lisfranc injuries?: Sports surgeons
21. What is the role of hardware in ORIF?: Maintains reduction, hardware
eventually removed
22. Role of hardware in fusion?: Compresses fusion, hardware left in place
23. What are lisfranc (diamond) plates indicated for?: 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
2/7
& FOREFOOT 70+ QUESTIONS
AND ANSWERS WELL VERIFIED
AND GRADED
1. Where is the lisfranc joint?: Spans the entire midfoot articulation with the
metatarsals
2. What is the keystone conformation?: Connection between 2nd met and
middle cuneiform that provides stability to lisfranc joint
3. What does the lisfranc ligament connect?: Medial cuneiform to base of 2nd
met
4. Three aspects of lisfranc ligament:: Dorsal, interosseous, plantar
5. What makes up the lisfranc complex?: 1st and 2nd met & medial and
middle cuneiform
6. What type of injury typically causes instability and gapping between
bones of lisfranc complex?: Axial load
7. Which column of the foot has the most flexibility?: Lateral column
8. What mechanisms of injury occur with lisfranc pathology?: Direct or
indirect, high energy or low energy
9. What constitutes a direct injury?: axial load with dorsal and plantar forces
10. What constitutes an indirect injury?: Plantarflexed foot with axial load
(heavy object falling on foot- tarsals shift anterior or posterior)
1/7
, .
11. What is necessary to diagnose lisfranc injury?: Weightbearing x-ray
12. What is a fleck sign?: Avulsion fracture between 2nd met and medial
cuneiform 13. What type of lisfranc injuries do not require surgery?:
Nondisplaced and stable
14. Lisfranc stability relies on ____ anatomy, while displacement relies on
_____ anatomy: Ligamentous, bony
15. What is a downside of fixing/fusing lisfranc injury with screws?: No
micromotion - they can break
16. What is a benefit of lisfranc ORIF with plates?: Plate fixation maintains
stability without violating the articular surface
17. What is ligamentous lisfranc augmentation (mini tightrope, internal
brace) typically indicated for?: Low energy injuries, mostly young adults and
highly active individuals
18. What is the gold standard for lisfranc injury fixation?: Plates and screws
19. What % of all fractures are lisfranc injuries?: 0.2%
20. Who treats most lisfranc injuries?: Sports surgeons
21. What is the role of hardware in ORIF?: Maintains reduction, hardware
eventually removed
22. Role of hardware in fusion?: Compresses fusion, hardware left in place
23. What are lisfranc (diamond) plates indicated for?: 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
2/7
