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Injuries of the midtarsal joint
The Journal of Bone and Joint Surgery. British Volume
|February 1, 1975
Summary
Midtarsal joint injuries, often misdiagnosed, require clear classification and treatment. This study details injury types, mechanisms, and recommended interventions for better patient outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Radiology
Background:
- Midtarsal joint injuries are frequently misdiagnosed.
- Accurate diagnosis and treatment are crucial for effective management.
- Understanding injury mechanisms aids in classification and therapeutic strategies.
Purpose of the Study:
- To clarify the mechanism, classification, and treatment of midtarsal joint injuries.
- To emphasize the importance of routine radiographic imaging.
- To describe a novel tarsal rotation or "swivel" injury.
Main Methods:
- Classification of 71 injuries based on the direction of deforming force (medial, longitudinal compression, lateral, plantar, crush).
- Description of injury mechanisms, including longitudinal compression fractures of the navicular body.
- Clinical and radiological assessment of treatment outcomes.
Main Results:
- Identified five main injury types, including a new "swivel" injury.
- Defined two varieties of longitudinal compression fractures of the navicular with different prognoses.
- Recommended reduction with internal fixation for displaced fractures, avoiding primary arthrodesis.
Conclusions:
- Non-operative management is not indicated for displaced fractures.
- Triple arthrodesis is recommended for severe persistent symptoms from medial and longitudinal force injuries.
- Calcaneo-cuboid arthrodesis is recommended for severe persistent symptoms from lateral force injuries.