In pes cavus, pronation becomes restricted due to the hypomobility in the subtalar and midtarsal
joints, and the center of gravity of the body shifts medially.
Tarsometatarsal joint complex and midtarsal
(MT) joint is in between ST joint and TMT joint which consists of two joints, namely, Talonavicular (TN) joint and Calca-neocuboid (CC) joint.
The model allows to separate the forefoot and the hindfoot and to analyze the midtarsal
In spite of all available measures, these two patients ultimately needed amputations- one was left midtarsal
amputation, and another was right below-knee amputation.
Joints assessed included the distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints of the hands; the wrist, elbow, shoulder, acromioclavicular, sternoclavicular, temporomandibular, hip, knee, ankle, and midtarsal
joints; and the metatarsophalangeal and proximal interphalangeal joints of the feet.
[8,13] In the case of pronation, the midtarsal
bones tend to unlock the subtalar joint, which in turn causes the cuboid and navicular bones to become more parallel, allowing the forefoot and midfoot to unlock.
However, in addition to the long duration of postoperative recovery, some patients are at risk of serious side effects including reflex sympathetic dystrophy, flat foot or posterior tibial nerve injury, and calcaneocuboid and midtarsal
joint pain [7,46].
This is known as a midtarsal
break and is similar to what the Boston team identified in some of their participants.
Among the foot cases, midtarsal
joints were frequently involved, while in a large series of foot and ankle tuberculosis, Calcaneus was involved frequently, followed by midtarsal
joints.8 As in our study, the delay in the diagnosis of osteoarticular tuberculosis is very common.
If the midtarsal
joint is flexible, it is generally agreed that gentle forces should be applied to orientate the forefoot so that the plane of the metatarsal heads are perpendicular to the vertical bisector of the calcaneus .