• Y H Teo and W Verhoeven.
• Department of Orthopaedic Surgery, Changi General Hospital, Singapore.
• Ann Acad Med Singap. 2004 May 1;33(3):362-4.

IntroductionWe present a rare case of plantar dislocation of the cuboid, fourth and fifth metatarsal joints. Fracture-dislocation in the midfoot region may be subtle and difficult to recognise at the emergency department.Clinical PictureA 16-year-old girl presented with lateral foot pain and swelling following a fall from a height of 3 m. Initial radiograph revealed a third metatarsal shaft fracture; however, additional views reviewed a plantar direction of fourth and fifth metatarsal dislocation from the cuboid.TreatmentOpen reduction and internal fixation with Kirschner wires followed by immobilisation in plaster was performed.OutcomeShe made an uneventful recovery and the wires had since been removed.ConclusionThis case was unusual in that there was lateral tarsometatarsal disruption with neither diastasis between the first and second metatarsals nor injury to either the first or second tarsometatarsal joints. The plantar direction of dislocation was also unusual as these injuries are usually dorsal.

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