Midtarsal Frx


- See:
       - Midfoot/Forefoot Fractures
       - Navicular Frx
       - Cuboid Frx
       - Longitudinal Stress Injuries of Midtarsal Joint

- Medial Stress Injury:
    - type of sprain of the midtarsal joint;
    - caused by inversion of the foot, inaddition, fracture subluxation of joint may be found;

- Lateral Stress Injury:
    - this injury is frequently misdiagnosed as an ankle sprain;
    - characteristic feature of these injuries is crushing of cuboid or anterior calcaneus as the forefoot is driven laterally;
    - avulsion fractures of navicular tuberosity are seen frequently, & navicular may subluxate laterally on the talar head;
    - Cuboid Frx is sometimes found with this injury:
         - cuboid is crushed between calcaneus and 4th & 5th metatarsals;
    - treatment includes initial non wt bearing cast for 6-8 weeks;

- Treatment:
    - often avulsion of navicular tuberosity is felt to be an isolated injury, and attention is not given to entire mid tarsal joint complex;
    - non displaced fractures may be treated by short leg plaster immobilization  until healed - usually 6 weeks;
    - is satisfactory reduction is not possible, try open reduction & K wire fixation or screw fixation;
    - when injury to this articular complex occurs in the diabetic patient w/ peripheral neuropathy, aaggressive treatment is indicated to avoid late collapse and Charcot arthropathy



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, September 4, 2012 8:13 pm