A Lisfranc injury , also known as Lisfranc fracture , is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. The injury is named after Jacques Lisfranc de St. Martin 2 April —13 May , a French surgeon and gynecologist who noticed this fracture pattern amongst cavalry men, in , after the War of the Sixth Coalition. The midfoot consists of five bones that form the arches of the foot the cuboid , navicular , and three cuneiform bones and their articulations with the bases of the five metatarsal bones , and these articulations are damaged in a Lisfranc injury. Such injuries typically involve the ligaments between the medial cuneiform bone and the bases of the second and third metatarsal bones , and each of these ligaments is called Lisfranc ligament. Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot and are often seen in traffic collisions or industrial accidents.
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Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displacement develops perpendicular to the surface of displacement, it is called a normal tensile crack or simply a crack ; if a displacement develops tangentially to the surface of displacement, it is called a shear crack , slip band , or dislocation. Brittle fractures occur with no apparent deformation before fracture; ductile fractures occur when visible deformation does occur before separation. Fracture strength or breaking strength is the stress when a specimen fails or fractures.
PE is a humbling disease. This is a highly heterogeneous disease, spanning the gamut from patients who are doing pretty well to patients who are profoundly ill. To complicate matters further, patients can evolve rapidly in one direction or the other. Given that PE is a heterogeneous and emergent condition, it should come as no surprise that our evidence basis is far from complete. This is a prime example of the lumping-vs-splitting paradox common in researching many critical illnesses:.
Average 4. His co-resident examines his hand under fluoroscopy and identifies the injury noted in Figures A and B. The muscle responsible for the primary deforming force in this injury is innervated by which nerve?