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.
Dislocations* ; Foot Joints ; Joints* ; Tarsal Joints

Chopart joint fracture and dislocation are rare injuries compared with other joint injuries with various clinical manifestations. Moreover, there is a lack of knowledge of the radiological findings of the joints, and thus, the extent of joint ligament damage may be underestimated, leading to improper treatment. This paper reports three cases of Chopart joint injury and seeks to reconsider the importance of Chopart joint evaluation and treatment.
Dislocations* ; Foot Injuries ; Joints* ; Ligaments ; Tarsal Joints

The Os Calcis is the largest bone of the tarsal bones. The incidence of fracture of the calcaneus is more frequent than that of any other tarsal bones. Fractures involving subtalar joint can usually cause serious and persistent disabilities and badly influence the patients psychologically, socislly and economically. But, there was no standardinzed treatment method for these fractures. Calcaneal fractures of 40 feet in 33 patients who were treated st department of orthopedic surgery, college of medicine, Kyungpook national university, from Jan. 1982 to Dec. 1986 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows. 1. Of the 33 patients, men were 25 (76%) and the mean age was 34 and 10 were in their thirties. 2. The most common cause of injury was a fall from height 23 patients (70%) and injury of the spine was most commonly associated. 3. Fractures involving the subtalar joint were 31 cases (78%) and 27 cases (68%) were Rowes type V. Of these Rowe's typeV, those of tongue type were 12 cases (30%) and joint depression type, 15 cases (38%). 4. In 17 cases of the fractures involving the subtalar joint, we had used Essex-Lopresti axial fixation method and obtained satiofactory results in 9 cases (53%). 5. The most common complications after treatment were persistent pain about foot and ankle. Of these, pain beneath the lateral malleolus was most frequent (9 cases).6. The more restored the Bohler's angle, the better the result.
Ankle ; Calcaneus ; Clinical Study ; Depression ; Foot ; Gyeongsangbuk-do ; Humans ; Incidence ; Joints ; Male ; Methods ; Orthopedics ; Spine ; Subtalar Joint ; Tarsal Bones ; Tongue

258 feet of patients with flatfoot were evaluated in this paper. The incidence of flatfoot is about 0.6% of the general population. The longitudinal arch was depressed in all of our cases of flatfoot, and there have been many patients suffering from pain after some kinds of heavy work. But there were no definite correlations found between the depression of the longitudinal arch and clinical symptom. The sag in the naviculo cuneiform joint is the most common X-ray finding in this series (93%), followed by the talo-navicular sagging (27%), Degenerative arthritis of the inter-tarsal joints was frequently found after the adolescent period. The talo-navicular joint was involved in arthritic changes in 60% of the cases, the subtalar joint 46% and the naviculo-cuneiform joint 42%. The prevalence of these changes was not increasing with the increasing age, so it is poatulated that the degenerative changes begin early in adolescent period. Accessory tarsal bones were more frequently seen in patients with flatfoot than in normal population. and the neck of the talus was usually deviated inferomedially. Now that the arthriric changes are very prevalent in the triple joints, there are many cases of flatfoot that should undergo the triple arth odesis inevitably if his conservative treatment was failed.
Adolescent ; Depression ; Flatfoot ; Foot ; Humans ; Incidence ; Joints ; Neck ; Osteoarthritis ; Prevalence ; Subtalar Joint ; Talus ; Tarsal Bones

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Foot ; Humans ; Incheon ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tarsal Bones ; Transplants

Calcaneus was the most commonly involved bone among the tarsal bone fracture. Many different methods have been tried for the treatment of fractures of the calcaneus in order to search for better results. But there is no general agreement on the treatment of the fracture of the calcaneus, especially involving the subtalar joint. From Jan. 1986 to Jan. 1990, 25 feet in 20 patients of calcaneal fractures involving the subtalar joint were treated by closed reduction & percutaneous pinning at the Dept. of Orthopedic Surgery, Chosun University Hospital and the results were as follows; 1. Of these intra-articular fractures, 15 fractures were tongue type and 10 fractures were joint depression type by Essex-Lopresti classification. 2. According to the Salama unit system, the results of treatment were excellent or good in 11 cases of 15 tongue types and 6 cases of 10 joint depression types. 3. The results were excellent in which reduction is achieved near anatomical reduction. 4. Even if the joint depression type fracture which is not severely comminuted, the treatment with closed reduction & percutaneous pinning is thought to be good method.
Calcaneus ; Classification ; Depression ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Methods ; Orthopedics ; Subtalar Joint ; Tarsal Bones ; Tongue

There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.
Arthritis ; Arthrodesis ; Dislocations ; Foot ; Tarsal Joints

PURPOSE: The purpose of this study was to compare the clinical and radiological results of single and double fusions in the transverse tarsal joint. MATERIALS AND METHODS: Between December 2000 and April 2009, 16 patients (16 feet) who had been treated by fusion of transverse tarsal joint were included in this study. In 8 patients, only talonavicular joint was fused and in the other 8 patients, both talonavicular and calcaneocuboid joints were fused simultaneously. We have measured talo-first metatarsal angle, calcaneal pitch angle, talonavicular coverage angle and presence of adjacent joint arthritis for radiological assessment at both preoperative and last visit. Furthermore, we have evaluated Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction. RESULTS: In a single fusion group, VAS was improved from 6.4+/-1.4 to 0.8+/-1.0 (p=0.0011) and AOFAS score was improved from 63.8+/-6.2 to 89.4+/-9.8 (p=0.0012). In a double fusion group, VAS was improved from 8.0+/-0.75 to 2.0+/-1.8 (p=0.0011) and AOFAS score was improved from 60.5+/-11.2 to 89.5+/-6.0 (p=0.0012). In the difference of talo-first metatarsal angle between two groups, a single fused group was more improved than a double fused group (p=0.04). CONCLUSION: Both single and double fusions are useful and attractive treatment for the transverse tarsal joint arthritis. Furthermore, a single fusion has advantages of less invasiveness and preserving some degree of hindfoot motion and could be an effective alternative to a double fusion if patient meets appropriate criteria through careful preoperative evaluation.
Animals ; Ankle ; Arthritis ; Foot ; Humans ; Joints ; Metatarsal Bones ; Tarsal Joints

PURPOSE: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint. MATERIALS AND METHODS: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients. RESULTS: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points. CONCLUSION: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.
Animals ; Ankle ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Hammer Toe Syndrome ; Hoof and Claw ; Humans ; Joints ; Metatarsal Bones ; Metatarsophalangeal Joint ; Orthopedics ; Osteotomy ; Range of Motion, Articular ; Toes

The treatment of open, traumatic intraarticular injuries to the metatarsophalangeal joint with severe articular comminution and cartilage defect of metatarsal head is a challenge to the foot surgeon. We report the joint reconstruction treating the injured joint by autogenic costal osteochondral graft with satisfactory outcome.
Cartilage ; Foot ; Head ; Joints ; Metatarsal Bones ; Metatarsophalangeal Joint ; Transplants