Midtfoten

Midtfoten, or the midfoot, refers to the region of the foot located between the hindfoot (rearfoot) and the forefoot. In human anatomy, it consists of five tarsal bones: the navicular, the cuboid, and the three cuneiform bones (medial, intermediate, and lateral). These bones form the arches of the foot and connect the hindfoot to the forefoot through the tarsometatarsal joints.

Anatomy and connections: The navicular sits medially and articulates proximally with the talus and distally with the three cuneiforms. The cuboid lies laterally and articulates with the calcaneus, the fourth and fifth metatarsals, and the lateral cuneiform. The cuneiforms bridge the navicular to the metatarsals and act as key stabilizers for the transverse arch. Ligaments surrounding the midfoot, including dorsal and plantar ligaments and the spring ligament, help maintain arch integrity and stabilize the joints between midfoot and hindfoot and forefoot.

Function: The midfoot acts as a flexible yet stable link that distributes load from the hindfoot to the forefoot. It participates in shock absorption during stance and provides a rigid lever for propulsion during push-off, while allowing adjustments to uneven ground.

Clinical relevance: Common concerns involve midfoot fractures, dislocations at the tarsometatarsal joints (Lisfranc injuries), and conditions affecting the arches such as tarsal coalitions or flatfoot deformities. Diagnosis relies on clinical examination and imaging (X-ray, CT, or MRI) to assess alignment and bone integrity. Treatment ranges from immobilization and rehabilitation for stable injuries to surgical reduction and fixation for unstable or displaced injuries. In pediatric care, attention to growth-related changes is important.

Etymology: The term midtfoten reflects its Scandinavian origins, describing the middle portion of the foot.