Occult Fracture-Subluxation of the Midtarsal Joint

Dewar, F. P.; Evans, D. C.

doi:10.1302/0301-620x.50b2.386

Cited by 70 publications

(44 citation statements)

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“…Auch wenn Frakturen des Os naviculare oder Os cuboideum noch gelegentlich isoliert betrachtet werden, muss entsprechend dem Luxationsmechanismus (s. Abb. 3a) bei Kompressions-und Avulsionsfrakturen dieser Knochen prinzipiell bis zum Beweis des Gegenteils von okkulten Bandverletzungen der jeweiligen Gegenseite ausgegangen werden [1]. Dies gilt umso mehr für "isolierte" Luxationen von Os naviculare oder Os cuboideum, welche einer systematischen Betrachtung nicht standhalten und in allen dokumentierten Fällen mit einer Bandruptur oder Avulsionsverletzung der Gegenseite und konsekutiver Instabilität im Chopart-Gelenk einhergehen [2].…”

Section: ᭤ Mediale Und Laterale Fußsäuleunclassified

“…Dewar u. Evans [1] beschrieben eine ᭤plantare Ekchymose als pathognomonisch für die Ruptur der der dorsoplantaren Aufnahme ist insbesondere darauf zu achten, dass sich der proximale Rand der Cuneiformia gleichmäßig mit dem distalen Rand des Os naviculare überschneidet und der kalkaneokuboidale Gelenkspalt nicht über 2 mm erweitert ist. In beiden Projektionen ist auf die gerade Ausrichtung der ᭤talometatarsalen Achse zu achten.…”

Section: Diagnostikunclassified

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Verletzungen des Chopart-Gelenks

et al. 2002

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Section: ᭤ Mediale Und Laterale Fußsäuleunclassified

Section: Diagnostikunclassified

Verletzungen des Chopart-Gelenks

et al. 2002

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“…Compression or avulsion fractures of the navicular or cuboid often cause ligament injuries on the opposite side because of the functional unit of the talonavicular and the calcaneocuboid joint [ 139 ] (Fig. 28.20a ).…”

Section: Epidemiology/etiologymentioning

confidence: 99%

“…For isolated calcaneocuboid arthritis, one should use the lateral approach and perform a calcaneocuboid arthrodesis [ 139 ]. If there is shortening of the lateral column, an interposition of tricortical bone graft is required.…”

Section: Surgery: Recommended European Standard Surgical Proceduresmentioning

confidence: 99%

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Foot and Ankle Injuries

Rein

Tan

Rammelt

et al. 2014

Bone and Joint Injuries

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Man's foot is all his own. It is unlike any other foot. It is the most distinctly human part of the whole of his anatomical make-up.Wood Jones (1944) [ 1 ]The goal of this chapter is to further the understanding of pathomechanisms, performing diagnostics and reconstructing of injured feet, and to demonstrate ways to treat malunions and nonunions. Regaining anatomic joints if possible and rebuilding the normal shape of the foot, even by fusion of joints, is a safe way to avoid pain and to restore function. Anatomy of the FootThe human foot contains 28 bones and is divided into three parts: the forefoot, the midfoot, and the hindfoot ( Fig. 28.1 ) [ 3 , 4 ]. ForefootThe forefoot contains the fi ve metatarsals and toes with two sesamoids under the fi rst metatarsal head and an inconstant sesamoid beneath the fi rst interphalangeal joint. Six weight-bearing surfaces are located at the metatarsophalangeal level (two sesamoids and four lesser metatarsal heads) and fi ve weight-bearing surfaces are located under the distal phalanges in a normal foot.The metatarsals are short tubular bones with a base, shaft, neck, and head. The heads of the metatarsals are strongly connected by the intermetatarsal ligaments. The fi fth metatarsal has a tuberosity at its base, where the plantar aponeurosis, the peroneus brevis, and the peroneus tertius tendon insert.The fi rst toe has two phalanges and the other four toes have three phalanges. The fi rst metatarsal is slightly shorter, broader, and more mobile than the three middle metatarsals, and normally bears as much as one-third to one-half of the body weight through the forefoot and plays a key role in the gait cycle. The metatarsophalangeal joints are ellipsoidal joints, but only the fi rst and fi fth rays allow fl exion/extension and ab-/adduction. The joint capsules are strengthened by collateral ligaments on either side.The two sesamoids at the fi rst metatarsophalangeal joint are well embedded in the capsuloligamentous complex; the medial (tibial) sesamoid is larger than the lateral (fi bular) sesamoid, corresponding to its more important role in weight bearing within the medial sulcus of the metatarsal head.The sesamoids are held together by the strong intersesamoid ligament and the plantar plate, which is fi rmly attached at the base of the proximal phalanx and loosely attached at the neck of the metatarsal via the capsule. The sesamoids are located within the two slips of the fl exor hallucis brevis tendon. The abductor hallucis tendon inserts at the medial sesamoid, the adductor hallucis tendon at the fi bular sesamoid.

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Sonographic diagnosis of a medial talar avulsion fracture

Hsu

Chiang

Liao³

et al. 2012

J of Clinical Ultrasound

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Occult talus fractures can be easily misdiagnosed as simple ankle sprains, resulting in painful nonunion, arthrosis, avascular necrosis, and long-term disability. We present a case of ankle injury with medial talar fracture that was negative on plain radiography but was diagnosed with sonography. Sonography is a valuable tool in screening ankle sprains and may assist clinicians in diagnosing the nature of ankle injury, thus guiding the most appropriate therapeutic strategy.

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Occult Fracture-Subluxation of the Midtarsal Joint

Abstract: 1. Occult fracture-subluxation of the midtarsal joint is described and illustrated by a typical case. 2. Comments are made on the mechanism of injury, diagnostic features and treatment.

Cited by 70 publications

References 0 publications

Verletzungen des Chopart-Gelenks

Verletzungen des Chopart-Gelenks

Foot and Ankle Injuries

Sonographic diagnosis of a medial talar avulsion fracture

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