DOI: https://doi.org/10.36347/sasjs.2026.v12i05.022

Pages: 450-455

Introduction: Open Lisfranc dislocation is a rare but severe midfoot injury characterized by disruption of the tarsometatarsal joint complex associated with significant soft tissue damage. Frequently overlooked during the initial assessment, it represents a major therapeutic challenge because of the high risk of instability, soft tissue complications, and infection. Case Presentation: We report on the case of a 23-year-old athletic patient who sustained a high-energy trauma following a fall from a significant height with direct impact to the midfoot. The patient presented severe pain and immediate functional impairment. Clinical examination revealed a 5-cm dorsal open wound associated with an obvious midfoot deformity and bone exposure, without neurovascular compromise. Radiographic assessment confirmed a complex open Lisfranc dislocation. Management and Outcome: Emergency surgical management was undertaken, including copious irrigation, antibiotic therapy, meticulous debridement, and anatomical reduction followed by percutaneous fixation using Kirschner wires. Postoperatively, the patient was immobilized in a cast with strict non-weight-bearing protocol. Follow-up demonstrated maintenance of satisfactory alignment with progressive functional recovery, without evidence of infection or major complications. Conclusion: Immediate percutaneous pinning represents a valuable salvage option in severe open Lisfranc injuries, providing rapid stabilization while minimizing additional surgical trauma to the soft tissues. In athletic patients, this minimally invasive approach may promote earlier functional recovery and improve the likelihood of returning to sports activities.