Evaluation of dorsal Lisfranc ligament deformation with load using ultrasound imaging

Abstract

Background: Research findings have linked dorsal Lisfranc ligament (dLL) rupture to complete Lisfranc ligament complex rupture; identifying deformation characteristics of the dorsal Lisfranc ligament alone may be helpful in diagnosing complete ligament rupture. The goal of the present study was to assess the deformation characteristics of the asymptomatic dLL using physiologically relevant stress/loads in a clinical setting and to discern normative dLL parameters.

Methods: Unilateral dLL measurements were taken from 50 healthy volunteers, using sonographic imaging under three different stress/load conditions. Stress/load was applied using the individuals' bodyweight (low-seated; medium-bilaterally equal weight bearing in standing; and high-single leg standing). Digital images of the dLL captured using ultrasound were visualized to determine the dLL length. One-way repeated measures ANOVA was used to assess changes in the dLL length with load.

Results: The average dLL elongation, as percent resting length change, was 8.76% between seated and single leg standing positions. Most of the dLL elongation (6.26%) occurred between seated and bilateral standing.

Conclusions: The deformation and role of the dorsal Lisfranc ligament can be observed using sonographic imaging resulting from physiological loading in the clinical setting.

Clinical relevance: These deformation parameters can be used to generate normative data for diagnostic purposes.

Keywords: Biomechanics; Lisfranc ligament; Midfoot; Ultrasound.