J Korean Foot Ankle Soc.  2017 Sep;21(3):108-112. 10.14193/jkfas.2017.21.3.108.

Fracture and Dislocation of the Midtarsal Joint: A Case Report

• Choi JC
• Jung YH
• Park SJ

• KMID: 2389941
• DOI: http://doi.org/10.14193/jkfas.2017.21.3.108

Abstract

The midtarsal joint is composed of the talonavicular and calcaneocuboid joints. It is also known as the Chopart joint. Midtarsal joint fracture and dislocation are relatively rare and frequently missed or misdiagnosed. A proper understanding about the anatomy of the midtarsal joint is an essential part in comprehending the mechanism of injury and rationale for treatment. Anatomical reduction of midtarsal joint with correction of the column in length and shape are important; however, it is technically challenging and may require open procedure. Herein, we described a case of initial open reduction and internal fixation for midtarsal joint fracture and dislocation with a brief literature review.

Keyword

Foot joint; Tarsal joints; Surgery

MeSH Terms

Dislocations*
Foot Joints
Joints*
Tarsal Joints

Figure

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  Figure 1 (A, B) Skin tenting (white arrows) is found in medial column because of inferolateral displacement of cuboid bone. Also, the midfoot and forefoot of left foot are more lateralized than right foot.

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  Figure 2 (A, B) Initial anteroposterior and lateral radiograph shows the plantar displacement of the cuboid bone with fracture of the anterior process of the calcaneus (white arrows). (C) Initial oblique radiograph shows navicular-medial cuneiform fracture and dislocation on lateral side (arrowhead), also shows that calcaneocuboid joint is impacted and inferolateral dislocation (white arrow).

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  Figure 3 (A) The sagittal computed tomography (CT) imaging shows the fracture of calcaneocuboid joint and inferolateral dislocation of cuboid bone. (B) Three-dimensional reconstructed CT scan shows lateral displacement of medial and intermediate cuneiform bone.

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  Figure 4 (A) Before the anatomical reduction and fixation, we can find calcaneocuboid joint fracture and dislocation in medial column. (B) After definite fixation of medial and lateral column, calcaneocuboid joint is stabilized.

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  Figure 5 (A) Intraoperative radiograph made after provisional fixation of the medial column and definitive fixation of the lateral column. (B) The radiograph shows anatomical reduction of the length and shape of lateral column.

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  Figure 6 (A~C) Immediate postoperative radiographs show anatomical reduction and stabilization of the midtarsal joint. (D~F) Follow-up radiographs, made at six months, show disuse osteoporosis of the foot.

Reference

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