Problems in the diagnosis, reduction, and maintenance of reduction of dislocations of the tarsometatarsal joints are discussed. Many different patterns may present due to the anatomy of the foot and ankle and the different mechanisms of injury. Closed reduction and maintenance of reduction may be difficult to achieve, and open reduction may be required. Fixation with multiple K wires is useful in maintaining reduction. The possibility of vascular compromise should be kept in mind. Although anatomical reduction should be the goal of treatment, this does not always assure a painless foot. Arthrodesis for traumatic arthritis is rarely indicated but is a satisfactory salvage procedure.