Fractures of the Tarsal Bone

Young Hwan Park; Hak Jun Kim; Soo Hyun Kim

doi:10.12671/jkfs.2016.29.4.276

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Park, Kim, and Kim: Fractures of the Tarsal Bone

Review Article

Journal of the Korean Fracture Society 2016; 29(4): 276-282.

Published online: 20 October 2016

DOI: https://doi.org/10.12671/jkfs.2016.29.4.276

Fractures of the Tarsal Bone

Young Hwan Park, M.D., Hak Jun Kim, M.D., Soo Hyun Kim, M.D.

Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Address reprint requests to: Hak Jun Kim, M.D. Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. Tel: 82-2-2626-3090·Fax: 82-2-2626-1164, dakjul@korea.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fractures of the tarsal bone, such as the navicular, cuboid, and cuneiform, are very rare. These injuries can lead to serious walking difficulties due to pain and deformity of the foot with delayed diagnosis of tarsal bone fractures during an injury to multiple lower extremities. The diagnosis can be done on simple radiographs. Sometime weight bearing radiographs or stress radiographs may be needed for further evaluation. Computed tomography is the most widely available diagnostic tool. Navicular and cuneiform account for the medial column of the foot, whereas cuboid for the lateral column. The treatment of tarsal bone fractures is primarily conservative management, but operative treatment is recommended for intra-articular displacement, dislocation, or shortening of the medial or lateral column of the foot. The operative treatments include screw fixation, plate fixation, or external fixation. Complications include malunion, nonunion, posttraumatic arthritis, avascular necrosis, and deformity of the foot. Tarsal bone fracture has to be evaluated carefully to prevent serious complications.

Keywords: Tarsal bone, Navicular, Cuboid, Cuneiform, Fracture

Figures and Tables

Fig. 1

Simple radiograph revealed the accessory navicular bone (white arrows).

Fig. 2

Sangeorzan's classification of navicular fracture. Type I: Dorsal or tuberosity Avulsion fracture, the primary fracture line traverse in the coronal plane, which is seen on a lateral radiograph. Type II: Navicular body fracture, in which the fracture line is traverse from dorsolateral to plantarmedial across the body, which is seen on an anteroposterior radiograph. Type III: Navicular body fracture with central or lateral comminution.

Fig. 3

(A) Type II navicular fracture and medial cuneiform subluxation were seen on an oblique radiograph. (B) Navicular fracture fragment and medial cuneiform were reduced and fixed with plate and screws.

Fig. 4

(A) Nutcracker fracture of cuboid was seen on an anteroposterior radiograph. (B) Bridging plate fixation was performed from the calcaneus to the fifth metatarsal bone to restore the length of the lateral column.

Fig. 5

Medial cuneiform fracture with Lisfranc injury was seen on simple radiograph and computed tomography.

Fig. 6

Fracture of the medial cuneiform and Lisfranc joint were reduced and fixated with plate and screws.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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