The Lisfranc injury is a complex injury of the midfoot. It can result in persistent pain and functional impairment if treated inappropriately. In Lisfranc fracture-dislocation treatment options are primary arthrodesis of the midfoot joints or open reduction and internal fixation with retaining of the midfoot joints. There is no gold standard for the treatment of these Lisfranc injuries as described in the current literature. In this health care evaluation, we will define the optimal treatment for the Lisfranc fracture-dislocation; either primary arthrodesis (PA) or open reduction and internal fixation (ORIF) in order to deliver better health care and lesser costs.