Lisfranc injuries come in many varieties and degrees of severity. It’s most commonly known to the public as an injury many NFL players have sustained; however, it is a common injury in my practice over the last several years among skateboarders, surfers, MMA fighters and weekend warriors. If suspect a Lisfranc injury, I will commonly order a stress x-ray, MRI or CT scan to evaluate the integrity if the TMTJ (Tarso-Metatarsal Joint). This is a type of injury that requires surgical repair. I often attempt to repair these injuries through a minimally invasive approach under fluoroscopic guidance. This is also the most commonly misdiagnosed foot injury outside of evaluation by a foot and ankle specialist. Left untreated, these injuries lead to an unstable arthritic midfoot and often lead to fusion years after the injury event.