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(BQ) Part 2 book "Diagnostic imaging of the foot and ankle" presents the following contents: Midfoot, forefoot, abnormalities of the plantar soft tissues, neurologic diseases, diseases not localized to a specific site, systemic diseases that involve the foot, tumorlike lesions, normal variants. | Chapter 4 Midfoot 4.1 Trauma 131 4.2 Chronic Posttraumatic and Degenerative Changes 145 4 4.1 Trauma 4 Midfoot 4.1 Trauma R. Degwert and U. Szeimies As described in the Integral Classification of Injuries ICI the midfoot consists of a proximal row of bones formed by the navicular and cuboid and a distal row formed by the medial intermediate and lateral cuneiforms. In the AO ASIF Arbeitsge-meinschaft fur Osteosynthese Association for the Study of Internal Fixation system the Chopart joint also called the midtarsal or transverse tarsal joint defines the boundary line between the midfoot and hindfoot and injuries to that joint are classified as midfoot injuries. The Lisfranc joint marks the distal boundary of the midfoot and injuries to that joint are assigned to the forefoot. 4.1.1 Fractures of the Tarsometatarsal Joint Line Lisfranc Fractures Definition A Lisfranc fracture is a fracture that involves the tarsometatarsal joint line with or without articular dislocation. The joint was named after Jacques Lisfranc who established the tarsometatarsal joint line as a level for foot amputations. Note Lisfranc fractures are among the most commonly missed severe foot injuries. They may alter the biomechanics of the foot leading to secondary degenerative changes and chronic pain. Not infrequently dislocations have already reduced spontaneously by the time the foot is examined and the patient presents with a severe capsuloligamentous disruption. Superimposed or unperceived signs and symptoms from other injuries are common as in the case of multiple trauma patients. Pain and swelling of the midfoot in a patient with no radiographic abnormalities should always prompt further investigation. Symptoms Pain and swelling predominantly affecting the medial column Inability to stand on the toes Limitation of motion Flattening of the pedal arches Shortening of the foot Possible compartment syndrome Predisposing Factors No specific predisposing factors are known. In principle any laxity
