The tarsometatarsal (TMT) joint refers to the region found in the middle of the foot. It is also called the Lisfranc joint. It is the junction between the tarsal bones (group of seven articulating bones in the foot) and metatarsal bones (a group of five long bones in the foot).
Fractures and dislocations of the Lisfranc joint are common injuries in sports such as football and rock climbing, when an athlete may land hard on a pointed foot. This can either break the bones in the midfoot, tear the strong ligaments that hold them together, or a combination of both. These injuries can sometimes look normal on xrays if the injury only involves the ligaments, so they can be missed initially. It is important to suspect a Lisfranc injury when there is much more swelling and pain in the midfoot, then would be expected by benign appearing xrays.
These fractures can be treated with or without surgery. If there is any instability in the midfoot (often determined by obtaining stress xrays), then surgery is usually required. Various techniques are used to stabilize the midfoot and fix any associated fractures. In extreme cases, the midfoot can be fused acutely if the fractures are not repairable.