The Foot

1

Radiographic examination

• AP

• Oblique

• Lateral

• Axial view of calcaneus

2

Common sites of injury in adults

• Metatarsals

  • Neck, base, shaft

  • Fifth MT – tuberosity, Jones’ fracture

• Phalanges

• Metatarsal/tarsal fracture-dislocation (Lisfranc)

• Calcaneus – compression fracture

• Talus

  • Neck

  • Lateral process (snowboarder’s fracture)

• Subtalar fracture-dislocation

• Chopart’s fracture-dislocation

• Navicular

  • Body

  • Proximal pole

• Tarsal avulsion

  • Lateral view

    • Head of talus

    • Anterior cortex navicular

    • Posterior tuberosity of talus

    • Dorsal surface of calcaneal tuberosity

    • Anterior process of calcaneus

  • AP view

    • Lateral surface of calcaneus

3

Common sites of injury in children and adolescents

• Metatarsal

  • Bunk bed fracture (buckle fracture base of first MT)

  • Apophysis base of fifth MT (do not mistake for fracture)

• Phalanges

  • Salter-Harris types 1 and 2 epiphyseal separation

• Calcaneus

  • Under age 14 – extra articular fx of tuberosity

  • Over age 14 – adult pattern intraarticular compression fx

• Talus

  • Nondisplaced fx of neck of talus; may be torus or buckle-type fx

4

Injuries likely to be missed

• Minimally displaced Lisfranc fracture-dislocations

• Fracture of adjacent metatarsals

• Lateral process fractures of talus (snowboarder’s fx)

• Subtle nondisplaced fractures of base of metatarsals

5

Where else to look when you see something obvious

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