DOI: https://doi.org/10.36347/sasjs.2026.v12i08.009

Pages: 687-693

Background: Neglected Lisfranc injuries may lead to midfoot deformity, chronic pain, and post-traumatic osteoarthritis. Delayed reconstruction is challenging because of periarticular fibrosis, soft-tissue contracture, and established bony deformity. Case presentation: A 26-year-old woman with no relevant medical history presented two months after a fall that caused a closed injury to the right foot in dorsiflexion and valgus. Examination showed angulation of the medial border at the first tarsometatarsal joint, midfoot tenderness, painful mobilization, and an antalgic limp, with preserved distal pulses and no neurological deficit. Radiographs and computed tomography demonstrated a complete divergent Myerson type C2 Lisfranc fracture-dislocation, associated with a malunited medial cuneiform fracture and a fracture of the base of the second metatarsal. Open reduction was performed through two dorsal approaches. The medial cuneiform malunion was taken down and reduced, followed by extensive tarsometatarsal arthrolysis, excision of interposed fibrosis, and sequential reduction of the medial, middle, and lateral columns. The reconstruction was stabilized with Kirschner wires. Outcome: The postoperative course was uncomplicated. The patient was immobilized in a windowed short-leg cast and remained non-weight-bearing for three months. The cast and wires were removed at 45 days, followed by non-weight-bearing rehabilitation. At six months, alignment remained globally maintained and the patient walked without pain. Conclusion: In a young patient with a Lisfranc injury neglected for several weeks, joint-preserving reconstruction may be considered when the deformity remains correctable and the articular surfaces are reconstructible. Correction of associated malunion, thorough arthrolysis, and methodical restoration of radiographic alignment are key steps. Longer follow-up is required to assess post-traumatic osteoarthritis.