midfoot

The midfoot is the region of the foot between the hindfoot (talus and calcaneus) and the forefoot (metatarsals and phalanges). It comprises the navicular, cuboid, and three cuneiform bones (medial, intermediate, and lateral). The midfoot forms the transverse arch and participates in weight transfer from heel strike to push-off.

The primary joints of the midfoot include the talonavicular and calcaneocuboid joints, which together constitute the transverse tarsal joint. The naviculocuneiform and intercuneiform joints, as well as joints between the cuboid and the bases of the metatarsals (tarsometatarsal joints proximally), contribute to midfoot motion and stability.

The midfoot functions to transmit forces from the hindfoot to the forefoot, adapt to uneven surfaces, and provide a rigid lever during propulsion while allowing flexibility in stance. The medial longitudinal arch is supported in part by the spring ligament (calcaneonavicular) and by plantar ligaments, with stability enhanced by the tibialis posterior tendon and intrinsic foot muscles.

Common conditions affecting the midfoot include Lisfranc injuries, which involve disruption of the tarsometatarsal joints and can accompany midfoot fracture-dislocations; navicular fractures; and chronic midfoot or midtarsal arthritis, particularly in diabetes (Charcot neuroarthropathy).

Imaging typically begins with weight-bearing radiographs (AP, lateral, and oblique views). MRI or CT may be used to assess complex injuries or occult fractures.