Center for Applied Biomechanics, University of Virginia, Charlottesville, Virginia, USA.
Bharti School of Engineering, Laurentian University, Sudbury, Ontario, Canada.
Orthop J Sports Med. 2014 Mar 7;2(3):2325967114525347. doi: 10.1177/2325967114525347. eCollection 2014 Mar.
Tarsometatarsal (TMT) dislocations are uncommon yet debilitating athletic injuries, particularly in American football. To date, the mechanisms of athletic TMT dislocation have been described only anecdotally. This lack of information confounds the development of preventative countermeasures.
To use video analysis to provide direct, independent identification of the etiologic and mechanistic variables responsible for TMT dislocations in professional football players.
Case series; Level of evidence, 4.
Sixteen professional National Football League players who sustained publicly reported TMT dislocations were identified. Publicly broadcast game footage of the plays in which injury occurred was reviewed by a panel of 5 biomechanists. Consensus was reached regarding the details surrounding injury, and a weighting was assigned to each detail based on the panel's confidence.
Roughly 90% of injuries occurred while the injured player was engaged with or by another player, a detail that has heretofore been undocumented. Few injuries resulted from direct loading of either the foot or the ipsilateral limb; however, the injured foot was frequently subjected to axial loading from ground engagement with the foot in plantar flexion and the toes dorsiflexed. Injurious loading was often due to external rotation of the midfoot (86%). Fifteen of 16 injuries were season ending.
TMT dislocations are frequently associated with engagement by or with a second player but infrequently caused by a direct blow to the foot. Axial loading of the foot, external rotation, and pronation/supination are the most common conditions during injurious loading.
跗跖关节（TMT）脱位在运动中较为罕见，但却极具破坏性，尤其是在美式足球中。迄今为止，运动性 TMT 脱位的机制仅通过传闻描述。这种信息的缺乏使得预防措施的制定变得复杂。
使用视频分析直接、独立地确定导致职业足球运动员 TMT 脱位的病因和力学变量。
病例系列；证据水平，4 级。
确定了 16 名曾遭受公开报道的 TMT 脱位的职业国家橄榄球联盟球员。由 5 名生物力学专家组成的小组对导致受伤的比赛录像进行了审查。针对受伤周围的细节达成了共识，并根据专家组的信心对每个细节进行了加权。
大约 90%的损伤发生在受伤球员与另一名球员接触或被另一名球员接触时，这一细节以前未被记录。很少有损伤是由于脚或同侧肢体的直接受力引起的；然而，受伤的脚经常受到来自地面的轴向力，脚处于跖屈和脚趾背屈的位置。受伤的负荷通常是由于中足的外旋（86%）。16 例损伤中有 15 例是赛季结束的。
TMT 脱位通常与与另一名球员的接触或被另一名球员接触有关，但很少是由于直接撞击脚部引起的。脚部的轴向负荷、外旋以及内旋/外旋是受伤时最常见的情况。
