+Total Dislocation of the Astragalus.+ This form of dislocation is much more frequent than those of the ankle joint proper, or of the articulation between the astragalus, calcaneus, and scaphoid. The displacement of the astragalus may occur in one of six directions: forward; outward and forward; inward and forward; inward; backward, and by rotation. The most frequent variety is the “outward and forward.” In this variety the foot is rotated markedly inward and the external malleolus is very prominent. The foot is in a clubfoot position. The dislocated astragalus can be felt as an irregular angular bone just below the external malleolus. +Treatment+ is the same as in subastragaloid dislocations. +Dislocation of the Metatarsal Bones.+ This may be either complete or incomplete at Lisfranc’s joint. It occurs most often in an upward direction. The dorsum of the foot is more convex than normal, while the sole of the foot is flattened. One can see and feel the displaced ends (upper) of the metatarsals on the dorsum of the foot. The foot is shortened and the toes point inward. Dislocations of the individual metatarsal bones are much rarer. The middle ones are displaced upward, and the first and fifth, inward and outward respectively. +Dislocation of the Toes.+ This occurs most often in the metatarsophalangeal joint of the great toe after forcible flexion. The dislocation may be complete or incomplete. In the former case, the proximal end of the first phalanx and the dorsum of the foot are prominent, and the head of the metatarsal bone projects on the sole of the foot. The reduction of toe dislocations presents no difficulties. +SPRAINS+ +Definition.+ A sprain is a joint wrench due to a sudden twist or traction, the ligaments being pulled upon or lacerated and the surrounding parts being more or less damaged. +Sprains of the Ankle.+ On account of its flexibility and constant use in weight-bearing, the ankle is the joint most frequently sprained. Sprains are common in a limb with weak muscles; in a deformed extremity in which the muscles act in unnatural lines, and in a joint with relaxed ligaments. A joint, once sprained, is very liable to a repetition of the damage from slight force. +Symptoms.+ The symptoms manifested in a sprain are as follows: severe pain in the joint; nausea and sometimes syncope; impairment, or loss of motion; severe pain upon motion; early swelling if hemorrhage is severe—in any case swelling begins in a few hours; movement of the joint becomes difficult or impossible; the tear in the ligament may be distinctly felt; in a day or two pain and tenderness become intense and discoloration becomes marked. +Diagnosis.+ Usually the diagnosis is easy to make, but in all doubtful cases an X-ray picture should be taken in order to be certain that a fracture does not exist.