Midtarsal sprains are common injuries of the foot but are often under-recognized both clinically and radiologically. They commonly occur with lateral ankle sprains.
In patients undergoing MRI for acute ankle trauma, up to 19% will have a midtarsal sprain 1.
The mechanism of injury can be inversion (most common, up to 75%) +/- plantarflexion, or eversion 1,2.
Inversion-related fractures in midtarsal sprains occur in three main patterns 1:
- lateral column distraction-related avulsion fractures
- medial column impaction fractures
- plantarflexion–related avulsion fractures
- dorsal talar head +/- dorsal navicular: dorsal talonavicular ligament
Eversion-related fractures in midtarsal sprains result in two main patterns 1:
- medial column distraction injuries
- navicular tuberosity: tibialis posterior avulsion / superomedial spring ligament
- lateral column impaction fractures
- calcaneocuboid joint impaction fractures
- 1. William R. Walter, Anna Hirschmann, Erin F. Alaia, Monica Tafur, Zehava S. Rosenberg. Normal Anatomy and Traumatic Injury of the Midtarsal (Chopart) Joint Complex: An Imaging Primer. (2018) RadioGraphics. 39 (1): 136-152. doi:10.1148/rg.2019180102 - Pubmed
- 2. William R. Walter, Anna Hirschmann, Erin F. Alaia, Elisabeth R. Garwood, Zehava S. Rosenberg. JOURNAL CLUB: MRI Evaluation of Midtarsal (Chopart) Sprain in the Setting of Acute Ankle Injury. (2017) American Journal of Roentgenology. 210 (2): 386-395. doi:10.2214/AJR.17.18503 - Pubmed