Injuries of the midfoot

Injuries of the midfoot are relatively rare but they can lead to significant morbidity if missed. Serious injuries may present in a subtle manner and are often misdiagnosed as a sprain. Small avulsion fractures of the navicular and cuboid may be misdiagnosed as a simple avulsion when in fact they represent a more severe midfoot injury. A high index of suspicion is required. Good quality X-rays with three views must be obtained and if suspicion exists further imaging with a bone scan, CT or MRI is necessary. Prompt diagnosis and early treatment will prevent long-term disability and morbidity. Salvage procedures following these injuries often involve arthrodesis that limit mobility and frequently lead to an unsatisfactory outcome.