Midfoot Injuries in Athletes: Fundamentals of Examination and Treatment

Anatomically, the midfoot acts as a solid construct connecting the hindfoot to the forefoot. Injury patterns to this structure occurring during athletics are characterized by relatively low-velocity loading mechanisms. “Midfoot injuries” in athletes are common and can be difficult to diagnose. They require a high level of clinical suspicion when evaluating an injured athlete's foot. Accurate diagnosis relies on a thorough physical examination and appropriate imaging studies. Plain foot x-rays are the primary imaging modality. These x-rays should be taken with the patient weight bearing whenever possible to allow alignment of the foot to be assessed and to help identify subtle instabilities. Occasionally, a magnetic resonance imaging, bone scan, or computed tomography is required to give more information on the nature of the injury. Treatment for many of these injuries is conservative. However, surgical intervention is sometimes required for unstable or significantly displaced injuries. Return to play can be prolonged, and several months of healing time is not uncommon.