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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

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