Midfoot Fractures Flashcards
What is the most common midfoot fracture?
Navicular fracture
What are the 4 types of navicular fractures?
Dorsal avulsion
Tuberosity
Body
Stress
What areas of the navicular have good and bad blood supply
Good - medial/lateral
Bad - central
What is the MOI for a navicular dorsal avulsion fracture?
PF w/ inversion
-talonavicular ligament
PF w/ eversion
-dorsal tibionavicular
When should you treat a navicular dorsal avulsion fracture surgically?
Fragment is still symptomatic
Fragment involves >20% of articular cartilage
What is the MOI of a navicular tuberosity fracture?
Eversion
Pull of the PTT or spring ligament causes avulsion
When should you treat a navicular tuberosity fracture surgically?
Non-union
Displacement
Large fragment
MOI of a non-displaced navicular body fracture?
Foot strikes ground in a plantarflexed position, the foot is then forced into a DF position w/ a pronated RF, the navicular then is trapped b/w cuneiforms and the talus
MOI of a displaced navicular body fracture
Foot strikes plantarflexed and then buckles at the midfoot causing the soft tissues to fail and allow displacement
3 types of displaced navicular body fractures
1 - transverse fx
2 - oblique fx
3 - central/lateral comminution
Displaced navicular body fractures are typically treated how?
ORIF w/ NWB short leg cast
Typical area for a navicular stress fracture
Central to lateral 1/3 of body due to it being relatively avascular
Navicular stress fracture treatment
NWB cast for 6-8 weeks
What are the 4 types of cuneiform fractures?
Avulsion
Body
Dislocation
Stress
An avulsion fracture of the medial cuneiform occurs because of what?
Pull of the TA tendon
MOI of a cuneiform dislocation fracture
Foot striking in a PF causing soft tissue to fail. Often seen with Lisfranc injury
What are the 3 types of cuboid fractures?
Avulsion
Simple body
Compression
Describe the cause of a cuboid avulsion fracture
Most common
-pull of the inferior CC ligament
MOI of a cuboid simple body fracture
Foot strikes in a PF position with axial or rotary forces
What is a “Nutcracker fracture”?
Cuboid gets caught b/w the bases of mets 4,5, and calcaneous.
Foot is ABducted in a PF position
How do you typically treat an avulsion fx or non-displaced fx of the cuboid?
WB in boot or cast for 6 weeks
