Release notes of Midfoot fractures

The content has been revised and extended by Khairul Faizi Mohammad (MY) and Brad Yoo (US), with Richard E Buckley (CA) and Markku T Nousiainen (CA) as executive editors.

Keen-Wai Chong (SG) helped to set up the table of content.

This edition now contains information on the management of:

• Chopart injuries
• Cuneiform fractures
• Cuboid avulsions
• Navicular avulsions

The following additional material has been created:

• Patient assessment
• Patient positioning/preparation

The midfoot material, second edition, includes a detailed description of the following injury types and their management.

Navicular avulsion fracture:

• Nonoperative treatment
• Lag-screw fixation
• Tendon reattachment (suture anchor)

Partial articular navicular fracture:

• Nonoperative treatment
• Lag-screw fixation

Complete articular navicular fracture:

• ORIF - Lag screw
• ORIF - Navicular plate
• Primary fusion of naviculocuneiform joint
• Temporary bridging of talonavicular joint

Cuboid avulsion fracture:

• Nonoperative treatment

Simple cuboid fracture:

• Nonoperative treatment
• Lag-screw fixation

Multifragmentary cuboid fracture:

• ORIF - Plate fixation
• Primary fusion

Cuneiform fracture:

• ORIF - Lag-screw fixation
• ORIF - Plate fixation
• Fusion

Treatment of Lisfranc (TMT) injuries

Treatment of Chopart injuries

Intertarsal crush injury:

• External fixation

Approaches:

• Dorsolateral approach to the cuboid
• Dorsal approach to multiple metatarsals
• Dorsal approach to single metatarsals 2–4
• Dorsal approach to the 1st metatarsal
• Dorsomedial approach to the navicular and cuneiform
• Medial utility incision to the navicular and cuneiform
• Percutaneous approach to the navicular
• Safe zones for pin and K-wire insertion in the foot

Patient preparations:

• Supine position

Further reading:

• Patient assessment
• Timing of surgery
• Compartment syndrome
• Talonavicular joint motion
• References

The content was revised by Richard E Buckley (CA) and Andrew Sands (US), with Joseph Schatzker (CA) as executive editor.

Mandeep Dhillon gave feedback on the content of the first edition. His comments and suggestions were considered and included by the editor Richard E Buckley (CA).

The midfoot material, first edition, included a detailed description of the following injury types and their management.

Navicular, split/stress:

• Nonoperative treatment
• Screw fixation

Navicular, multifragmentary:

• ORIF - plate fixation

TMT (Lisfranc) injuries:

• ORIF - screw fixation

Simple cuboid:

• Nonoperative treatment

Cuboid, crush:

• ORIF - plate fixation

Intertarsal fractures:

• ORIF - plate fixation

Intertarsal crush:

• External fixation

Approaches:

• Dorsomedial to the navicular
• Percutaneous to the navicular
• Dorsal approach to midfoot and metatarsals
• Dorsolateral to the cuboid
• Medial utility incision

Further reading:

• Compartment syndrome