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Dislocations of the Tarsometatarsal Joint
ALEXANDER P. AITKEN; DON POULSON
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1180 Beacon Street, Brookline 46, Massachusetts Straub Clinic, 1000 Ward Avenue, Honolulu, Hawaii
1963 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1963; 45:246-383 
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Abstract

A series of nine cases of tarsometatarsal dislocation due to indirect trauma with a follow-up from two and a half to fifteen years is presented. Distinction is made between dislocations due to direct and those due to indirect trauma. It is our opinion that, despite the superficial similarity between the two, the lesions are quite different in mechanism of production, direction of displacement, and extent of soft-tissue damage. Their treatment and prognosis also differ. In this series, all the dislocations were due to indirect violence; seven cases were fresh and two were old injuries of months' or years' duration.

Reduction was accomplished by closed and open methods. Partial redislocation occurred after both methods in some instances. Two patients had persistent marked dislocation. In all patients followed for two and a half years or more the functional end results were excellent even when severe widespread dislocation persisted. Despite these facts, we believe when dislocation recurs or when closed methods of reduction fail, open reduction and internal fixation with Kirschner wires are advisable. Open reduction provides a better looking foot and appreciably hastens convalescence. In this series none of the dislocations, not even the persistent widespread ones, caused symptoms that suggested the need for surgical fusion. Although disastrous circulatory disturbances have been described in the literature, none were experienced in this series.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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