Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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PASSIVE TESTS OF THE MIDTARSAL JOINTS

Remarks

• Because the middle segment of the foot consists of several bones and joints it is very difficult to assess isolated movements. Therefore the whole middle segment is
considered as one integrated structure.

• Movements are possible in three directions but owing to anatomical characteristics plantar flexion is always accompanied by some adduction, and dorsiflexion by some abduction.

• The positioning for all the midtarsal movements is the same. Positioning for testing the midtarsal mobility. The subject lies supine with an extended knee and
the foot in neutral position. The examiner is distal to the foot. His contralateral hand encirdes the heel and carries it. The hand also pulls on the heel and forces it into full valgus. The ipsilateral hand encirdes the forefoot, thumb under the
metatarsal heads and fingers at the dorsum of the metatarsal shafts.

In this position both ankle and subtalar joints are fully stabilized:

• The traction forces the talus into a dorsiflexed position between the two malleoli.
• The valgus position fixes the subtalar joint.

Common pathological situations for the midtarsal
tests:

• LimHation may indicate arthritis or arthrosis.
• Painful movement with an excessive range is typical for the beginning of a midtarsal strain.
• Localized pain indicates a local ligamentous lesion or local periostitis.

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