Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute left midfoot pain following a traumatic injury. Reports inability to bear weight on the affected extremity. Describes localized swelling, ecchymosis along the plantar aspect of the midfoot, and exacerbation of pain with attempted ambulation or midfoot rotation. No history of prior foot surgery or chronic midfoot pathology.
Clinical Examination Findings
Left foot examination reveals significant edema and ecchymosis localized to the dorsal and plantar midfoot. Tenderness to palpation noted over the tarsometatarsal (TMT) joint complex. Positive pain elicited during midfoot abduction and pronation stress testing. Neurovascular status intact with palpable dorsalis pedis and posterior tibial pulses; capillary refill < 2 seconds. No evidence of compartment syndrome.
Treatment Protocol
Immediate immobilization in a non-weight-bearing posterior splint. Strict non-weight-bearing status for the left lower extremity. Pain management initiated with NSAIDs and elevation of the foot above heart level. Referral for urgent orthopedic surgical consultation for definitive management, including potential ORIF (Open Reduction Internal Fixation) pending advanced imaging (CT/MRI) results.