Foot Case 1 History/Physical Exam

Typical mechanisms are:

1. Rotational forces with the body rotating around a fixed forefoot
2. Axial loading in which the hindfoot is driven into the bases of the metatarsals
3. Crush injuries

Physical exam reveals plantar midfoot ecchymosis and swelling, pain along the TMT joint with palpation, motion, or weight-bearing, and midfoot instability. Patients typically cannot bear weight. A careful vascular exam should be performed because there can be damage to a branch of the dorsal pedis artery which crosses the base of the first and second metatarsals.