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Plantar-Flexion Tarsometatarsal Joint Injuries in Children

Buoncristiani, Anthony M. M.D.; Manos, Richard E. M.D.*; Mills, William J. M.D.

Journal of Pediatric Orthopaedics: May-June 2001 - Volume 21 - Issue 3 - p 324-327

We are reporting a series of eight patients ranging in age from 3 to 10 years who sustained plantar-flexion injuries of the foot, resulting in injuries to the tarsometatarsal (TMT) interval. All injuries were identified within 3 days and treated with molded short leg immobilization. We evaluated all patients an average of 32 months after injury with physical examination and the Midfoot Functional Rating (MFR) score. Seven patients had no limitations in their activities of daily living or athletic endeavors. These seven patients had MFR scores of 100. One patient had complaints of midfoot pain with running for >5 min and radiographic evidence of degenerative changes across the TMT interval at 3-year follow-up. These results suggest that although indirect pediatric TMT injuries have a generally favorable prognosis, early degenerative changes can occur and may be responsible for chronic pain and activity limitation. Degenerative changes in this weight-bearing region in a young patient can have lifelong implications. Patients and parents may benefit from discussion of the potential for future midfoot compromise following this injury.

Study conducted at Naval Medical Center San Diego, San Diego, California, U.S.A.

From the Department of Orthopaedics, University of Washington, Seattle, Washington, and *Department of Orthopaedics, Naval Medical Center San Diego, San Diego, California, U.S.A.

Address correspondence and reprint requests to Dr. William J. Mills, Department of Orthopaedics, Harborview Medical Center, Box 359798, 325 9 Avenue, Seattle, WA 98104-2499, U.S.A. (e-mail:

© 2001 Lippincott Williams & Wilkins, Inc.