Trauma to the medial ray of the foot: A classification of patterns of injury and their management

Abstract

Aims: Fractures and dislocations of the midfoot are relatively uncommon but can be life changing injuries. Within the literature, there has been scant specific reference to the identification and management of medial ray injuries in midfoot trauma. Moreover, it is appreciated that these injuries are associated with poor outcomes. We aim to clearly define these injury characteristics and demonstrate fixation techniques.

Patients and methods: A retrospective review of the case notes and imaging was conducted for operatively treated midfoot injuries between January 2013 and January 2018.

Results: 161 patients were identified, 31 of these with imaging and operative diagnosis suggestive of medial ray injury. Studying these 31 injuries revealed five patterns of injury.

Conclusion: When treating midfoot trauma, it is important to fully understand the injury pattern as this dictates the principles and techniques of fixation. Identification and knowledge of these five injury patterns will aid surgeons in future management of these injuries and may improve treatment outcomes.

Keywords: Classification; Column theory; Foot trauma; Midfoot trauma.