Midtarsal joint injury - extra-articular avulsion fractures

Discussion:

Avulsion fractures of the dorsal talonavicular ligament may not be as innocuous as other cortical avulsion fractures as they can be an indirect sign of midtarsal instability. As seen in this case, there is a fracture of the lateral aspect of the anterior calcaneal process, presumably involving the dorsal calcaneocuboid ligament, that was occult on x-ray. 

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