Tarsometatarsal joint dislocation or fracture dislocation
Shen, C.W.; Ma, Y.Z.; Ye, Y.Q.
Chinese Medical Journal 96(7): 517-521
1983
ISSN/ISBN: 0366-6999 PMID: 6418452 Document Number: 207912
From a review of 60 patients with tarsometatarsal dislocations or fracture dislocations, it is shown that careful X-ray analysis can detect incomplete dislocation. X-rays with the foot in 60.degree. eversion help in diagnosing dorsal displacement of the 1st or 2nd metatarsal base. For exploring vessels in cases complicated by circulatory embarrassment, the dorsalis pedis artery must be explored first from the dorsal foot wound in compound injuries, while the posterior tibial vessels must be first explored in closed injuries. Internal fixation with Kirschner wire is insufficient to counteract the tension exerted by muscular pull. Percutaneous suture with stainless steel wire provides sufficient force for good reduction. Following tarsometatarsal joint arthrodesis, care must be taken to mold the cast so that immobilization ensures good foot alignment preventing deformity.