The scaphoid (Os naviculare)

The scaphoid lies between the talus and the three sphenoid bones. With each of these bones the scaphoid is in a jointed connection. It is also part of the lower ankle joint.

Three wedge legs (Ossa cuneiforme)

The three sphenoid bones are divided into a central (medial) bone, a lateral (lateral) and an intermediate (intermedial) tarsal bone. The three sphenoid bones are decisive for the transverse curvature of the foot. In addition, they form articulated connections with the metatarsal bones I-III (Ossa metatarsi I- III) in the front of the foot and articulate laterally with each other and with the scaphoid. Furthermore, the lateral sphenoid bone (Os cuneiforme laterale) is connected to the cuboid bone and forms a joint here.

The cuboid bone (Os cuboideum)

The cuboid bone has a pyramid-shaped structure and forms a wide variety of joint connections:

To the rear (dorsal), the cuboid bone articulates with the calcaneus.
To the front (ventral), articulated connections are formed with the metatarsal bones IV and V (Ossa metatarsale IV/V).
In addition, the central surface of the cuboid bone has a joint surface to form a joint with the lateral sphenoid bone (Os cuneiform lateral).

Fracture of one or more tarsal bones

A fracture of one or more tarsal bones usually occurs as a result of an accident, fall or a direct violent impact, for example a blow to the foot. Especially the ankle and heel bone are most frequently affected by fractures. As a result, the affected person often feels pain in the foot, which can be so severe that the foot can no longer be loaded.

In addition, the foot is usually clearly swollen, overheated and reddened. This can lead to the development of a bruise. In order to diagnose the fracture of the tarsal bone, x-rays are taken in several planes on which the fracture can be identified.

In some cases, a CT or MRI may be necessary to rule out concomitant injuries to the surrounding soft tissues. It is also necessary to check whether important nerves were damaged in the accident.Depending on the severity of the fracture, different therapeutic measures can be applied. If it is a simple fracture in which the bone fragments have not shifted against each other, surgery is not necessarily required.

In this case, a conservative therapy can be tried, in which the foot is immobilized and stabilized with a plaster cast. The foot must not be subjected to any load for about eight weeks. Physiotherapeutic exercises are therefore recommended to maintain and improve the mobility and function of the muscles so that the patient can quickly return to normal walking once the fracture has healed.

If the fracture is complicated, if the bone parts have shifted against each other or even if pieces of bone have entered the joint space, surgery is often necessary to achieve a good therapeutic result. The bone fragments are brought back into their anatomically correct position and fixed with screws, wires or plates. Even after the operation, the foot must not be loaded for several weeks to allow the bone to heal. The physiotherapeutic exercises are performed in the same way as for the non-surgical treatment of the fracture. In most cases, very good results can be achieved.