Abstract
The bony and ligamentous structure of the foot is a complex kinematic interaction, designed to transmit force and motion in an energy-efficient and stable manner. Visible deformity of the foot or atypical patterns of swelling should raise significant concern for foot trauma. In some instances, disruption of either bony structure or supporting ligaments is identified years after injury due to chronic pain in the hindfoot or midfoot. This article will focus on injuries relating to the peritalar complex, the bony articulation between the tibia, talus, calcaneus, and navicular bones, supplemented with multiple ligamentous structures. Attention will be given to the five most common peritalar injuries to illustrate the nature of each and briefly describe methods for achieving the correct diagnosis in the context of acute trauma. This includes subtalar dislocations, chopart joint injuries, talar fractures, navicular fractures, and occult calcaneal fractures.
Highlights
Fractures and ligamentous injuries of the foot are significant and challenging entities in the context of orthopaedic trauma [1]
In the acute trauma patient, priority is given to executing ATLS protocol and emergent resuscitation
Subtalar joint stability is primarily dependent on ligamentous structures, as described above
Summary
Fractures and ligamentous injuries of the foot are significant and challenging entities in the context of orthopaedic trauma [1]. Hindfoot injuries, peritalar fractures and dislocations, have received significantly less attention Both are relatively rare in the context of orthopaedic trauma; the previous literature has demonstrated a significant increase in morbidity of polytraumatized patients with an untreated foot injury [5]. Together with occult fractures of the calcaneus and navicular, these form roughly 70% of all missed foot injuries in high and low energy trauma [3]. The bony and ligamentous structure of the foot is a complex kinematic interaction, designed to transmit force and motion in an energy-efficient and stable manner. Disruption of either bony structure or supporting ligaments results in long-term functional deficits, sometimes only identified years after injury by chronic pain in the hindfoot or midfoot due to progressive wear and strain. E following sections will review the five most common peritalar injuries in order to illustrate the nature each and briefly describe methods for achieving the correct diagnosis in the context of acute trauma
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