Hardcastle & Myerson classification for Lisfranc injuries

The Hardcastle and Myerson classification system is used to categorize injuries to the Lisfranc joint complex, which involves the tarsometatarsal joints in the midfoot. This classification system helps surgeons and medical professionals assess the severity of Lisfranc injuries and guide treatment decisions. Lisfranc injuries can range from mild sprains to severe fractures and dislocations.

The Hardcastle and Myerson classification system is divided into three main categories, which are further sub-divided based on the severity of the injury:

Type A: Homolateral Fracture Dislocation

  1. Type A1: Fracture of the base of the second metatarsal.
  2. Type A2: Fracture of the first and second metatarsals.
  3. Type A3: Fracture of all three medial metatarsals.

Type B: Isolated Lisfranc Ligament Injuries

  1. Type B1: Sprain or rupture of the Lisfranc ligament with or without fractures.

Type C: Divergent Dislocation

  1. Type C1: Dislocation of one or two metatarsals.
  2. Type C2: Dislocation of three or more metatarsals.

Each type is associated with varying degrees of instability and severity. Treatment options and outcomes depend on the specific type of Lisfranc injury.

It’s important to note that Lisfranc injuries can be complex and may require careful evaluation by a medical professional, often including imaging studies like X-rays or CT scans. Treatment can range from non-surgical approaches (such as casting or bracing) for less severe injuries to surgical intervention (such as stabilization with screws or plates) for more severe injuries.

If you suspect a Lisfranc injury, it’s crucial to seek prompt medical attention to ensure an accurate diagnosis and appropriate management to prevent potential long-term complications, such as chronic pain and instability in the midfoot.