Midtarsal sprain

Midtarsal sprains are common injuries of the foot but are often under-recognized both clinically and radiologically. They commonly occur with lateral ankle sprains.

Epidemiology

In patients undergoing MRI for acute ankle trauma, up to 19% will have a midtarsal sprain .

Pathology

The mechanism of injury can be inversion (most common, up to 75%) +/- plantarflexion, or eversion .

Inversion-related fractures in midtarsal sprains occur in three main patterns :

• lateral column distraction-related avulsion fractures
  • anterior calcaneal process
    • bifurcate ligament
    • extensor digitorum brevis (less common)
  • dorsal calcaneocuboid: dorsal calcaneocuboid ligament
• medial column impaction fractures
  • navicular body fracture
  • talar head osteochondral fracture
• plantarflexion–related avulsion fractures
  • dorsal talar head +/- dorsal navicular: dorsal talonavicular ligament

Eversion-related fractures in midtarsal sprains result in two main patterns :

• medial column distraction injuries
  • navicular tuberosity: tibialis posterior avulsion / superomedial spring ligament
• lateral column impaction fractures
  • calcaneocuboid joint impaction fractures

Associations

• lateral ankle sprain
• deltoid ligament sprains 

Siehe auch:

• Ligamentum talonaviculare