Interposition of the Anterior Tibial Tendon between the Medial and Intermediate Cuneiforms in Lisfranc Injuries: Report of Two Cases

Total lateral incongruity type Lisfranc injury may cause skin problems and compartment syndrome, manual reduction and temporary immobilization are usually needed. However, sometimes-manual reduction is not easy to achieve due to the prevention of reduction by interposed soft tissues. We report two cases of irreducible Lisfranc injuries due to interposition of the anterior tibial tendon between the medial and intermediate cuneiform bones. Our recommendation for manual reduction in total lateral incongruity with suspicion of the anterior tibial tendon’s interposition is to push up the forefoot dorsally under the distraction, abduct the forefoot, displace the forefoot medially, and adduct the forefoot in sequence.