Abstract
Purpose: Severe trauma in the mid-foot induces various foot deformities, causing pain. The mechanism and treatment of foot deformities following mid-foot trauma were evaluated.
Materials: We evaluated feet showing dislocation and/or fracture of 2 or more joints or 2 or more tarsal bones encountered at our department between 1983 and 1996. The subjects were 24 males (26 feet) and 8 females (8 feet) aged 21–58 years (mean, 37 years). The injury that caused foot deformities was navicular bone fracture in 1 case, Chopart dislocation in 3, Lisfranc dislocation in 23, and fracture dislocation of the cuneiform in 5, The follow-up period was 2 years and 4 months _ 8 years (mean, 4 years and 9 months). Deformities occurred in these cases and associated factors were evaluated.
Results: Flat foot deformity occurred in the 1 case of navicular bone dislocation and 2 of fracture dislocation of the cuneiform. Cavovarus deformity occurred in the 6 cases of Lisfranc fracture dislocation. Other deformities were observed in 3 feet. All patients complained of pain and fatigability during walking and were treated by corrective osteotomy and arthrodesis. Though the pain reduced, discomfort in the foot persisted, making heavy labor impossible in 3 cases.
Discussion: In the mid-foot, there are many small tarsal bones, to which many tendons and ligaments are attached, forming the foot arch. Even though injury of one joint or one ligament (tendon), foot deformity can be induced. It is also possible that intraarticular injury was already severe at the time of injury, inducing secondary deformity. In trauma of the mid-foot involving multiple joints, the injured area should be adequately evaluated by preoperative stress X-P or MRI.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
