Missed Medial Swivel Type of Midtarsal Injury Presenting Late with Deformity - A Case Report

Midtarsal injuries, especially pure dislocations and subluxations, are commonly missed injuries, often misdiagnosed as sprains, due to the occult nature of radiographic findings. The authors present one such case of missed midtarsal and subtalar subluxation with extra-articular calcaneum fracture and 2nd metatarsal shaft fracture, which ended up in equinus, forefoot adduction, midfoot inversion, and missed due to prolonged immobilization.

We present the findings in a 24-year-old active male patient, who sustained a fall from his 2 wheeler and was treated for Right Extra articular calcaneum fracture with 2nd metatarsal fracture elsewhere, developing a gradual equinus, adduction and supination deformity at the mid foot over 6 months and was eventually treated by the authors with tendoachilles lengthening with midfoot and tibiotalar with subtalar fusion using tibio-talo-calcaneal nail and beam screws due to the chronicity of the injury.

There are multiple articles describing acute medial swivel midtarsal dislocations, but none portraying a chronic gradual subluxation without fracture. The radiographical findings do not place this patient in any present classification present; the authors consider it a missed medial swivel type midtarsal subluxation with subtalar subluxation of the right side.