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Background: Lisfranc injuries are potentially severe but relatively uncommon. Limited epidemiological data regarding Lisfranc injuries of the midfoot are available. This study aimed to describe the injury's epidemiology, injury mechanism, and primary treatment.

Methods: An observational register study examined all Lisfranc injuries registered in the Swedish Fracture Register from 2013 to 2022. Data on sex, age, date of injury, injury type, injury mechanism, and primary treatment were analysed.

Results: Some 2084 Lisfranc injuries in 2079 patients (54 % men) were included in the study. The mean age at injury was 43 (18-92, SD 17.3) years for men and 49 (18-96, SD 17.4) for women. One of five cases were caused by high-energy trauma, and the most common injury mechanism was a simple fall - tripping (31 %). Approximately 39 % of patients underwent operative treatment, with fixation using plates (51 %) being the prevailing choice of treatment. Primary arthrodesis was performed in 11 % of the operatively treated cases.

Conclusions: Lisfranc injuries are the consequence of a broad spectrum of injury mechanisms, are primarily induced by low-energy trauma and found in all age groups in adults. The majority of Lisfranc injuries are treated non-operatively. This comprehension can aid in accurate diagnosis and management in everyday clinical practice.Keywords: Lisfranc injury; Swedish Fracture Register; Trauma epidemiology.