Mechanism of injury
Indirect
trauma caused by forced inversion/eversion of the foot. Forced plantar flexion
of the foot.
Clinical presentation
Swelling of the tarsus, pain to the foot on weight bearing.
Diagnostics
Physical examination: Swelling and local tenderness.
X-ray examination: X-rays of the foot in two planes, ie, AP view and oblique view. Comparative x-rays of the other foot if necessary.
This fracture is often missed on x-ray. If in doubt, take more x-rays or perform a CT scan.
Classification
None.
Treatment
Conservative treatment: In
nondisplaced fractures: short-leg cast for 4–6 weeks
Surgical treatment: For
displaced fractures use open reduction and screw osteosynthesis, followed by
nonweight-bearing ambulation with crutches or short-leg cast for 4 weeks.
Duration
Injury takes 4−6 weeks to heal. Duration of
disability is 6−8 weeks.
Prognosis
Prognosis is good. If symptoms persist and special
shoes are not effective, arthrodesis of the surrounding joint(s) is indicated.
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