Lisfranc injury sustained from sudden twisting motion on uneven ground. Arrows point to dislocations of the tarsophalangeal joints. Rare, but extremely debilitating. Mechanismis either 1. Sudden torque on the foot (a runner falling into a hole) 2. Axial loading (e.g. rugby player with forefoot fixed on ground, dorsiflexed, and another player landing on the heel), 3. Direct Trauma (dropping heavy object onto foot), usually open fractures.