Injuries of the tarso-metatarsal joints. Etiology, classification and results of treatment.

Analysis of the clinical cases (Figs. 1 to 27) suggested that the injuries could be classified into five types (Table I). This classification was confirmed by experiment (Figs. 28 to 40). A review of sixty radiographs previously published showed that all but three could be classified within this scheme. Cases 1 5 and 17 in the present series are not typical, but a reasonable approximation could be found (Figs. 16 and 1 8). The fifth group of plantar-flexion injuries may escape detection unless the radiographs are studied closely (Figs. 26 and 27). Qu#{233}nu and Kflss (1909) pointed out that the medial cuneiform and navicular bones and the talus form parts of the same anatomical column as the first metatarsal bone. Displacement of the latter with all or part of the former (Fig. 18, Case 17) represents the same basic injury as dislocation of the first metatarsal bone alone. Similarly, on the lateral border of the foot, fractures of the cuboid bone (Figs. I, 5, 1 1 and 12; Cases 1, 5, 1 1 and 12 (right)) could be included with first or second degree supination and second degree pronation injuries.