Lisfranc injuries in children are rare and range from mild midfoot sprains to severe traumatic fracture-dislocations. Management of sprains is nonoperative, whereas treatment of fracture-dislocations often requires internal fixation. We present a unique case of a midfoot sprain in a 14-year-old adolescent boy, with gradual increased instability at the joint owing to attenuation of the Lisfranc ligament. Closed reduction and percutaneous pinning resulted in successful treatment at 3 weeks postoperatively. Midfoot sprains may lead to further ligamentous attenuation and widening as seen on radiographs and thus should be monitored for signs of persistent pain and instability. Because midfoot instability contributes considerably to posttraumatic arthritis, we recommend reduction when nonoperative interventions are unsuccessful.

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