Foot & Ankle Surgery: Techniques, Reports & Cases (Jan 2021)

The piano key test: When and How, a survey

  • Melissa Rossi, DPM,
  • George F. Wallace, DPM, MBA

Journal volume & issue
Vol. 1, no. 2
p. 100022

Abstract

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Lisfranc or tarsometatarsal joint fracture dislocations represent 0.2% of all fractures. It has been estimated that the diagnosis is missed 20% of the time. The medical field is replete with various clinical tests to aid in formulating diagnoses, many of which have either a person's name or some other identifier. An example of one of these clinical tests, the Piano Key Test, has been associated with Lisfranc injuries. A survey was forwarded to residency directors regarding their familiarity with the test, how they performed it, and if not what alternatives they use instead. A total of 232 surveys were mailed with 65 returned. Forty respondents heard of the test while the remaining 25 had not. Out of the 40 individuals who had heard of the test, 31 use it in their practice. There are many ways the test is being performed with no consensus. The Piano Key Test can be used for pathology related to the tarsometatarsal joints in an acute or chronic setting.

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