Arthrodesis of the talonavicular-cuneiform joints in Müller-Weiss disease

Retana, Pablo Fernández de; Maceira, Ernesto; Fernández-Valencia, Jenaro Á.; Suso, S.

doi:10.1016/s1083-7515(03)00175-x

Cited by 61 publications

(79 citation statements)

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“…Pes planus was shown in most (90%) feet in this study, which is similar to previous reports. Because fragmentation affects the lateral part of the navicular, the talar head protrudes outwards, resulting in pes planovarus [3, 7]. Paradoxical pes planusvarus suggests an advanced stage of disease and is usually associated with prominent calcaneum posteriorly due to relative advancement of the tibia in relation to the tarsal joints.…”

Section: Discussionmentioning

confidence: 99%

“…But in MWD, the lack of bone stock makes it very difficult to perform the operation ideally since the bone is necrotic. Maceira et al [7] reported unsatisfactory results of internal fixation in the presence of arthritic changes around the navicular bones. Percutaneous decompression of the navicular was suitable for early stages of MWD.…”

Section: Discussionmentioning

confidence: 99%

“…For the treatment of MWD, many researches suggest initial non-surgical treatment, range from 2 [7] to 60 [8] months. Conservative management is composed of insoles, orthoses, decreased physical activity, non-weightbearing cast immobilization, and/or nonsteroidal anti-inflammatory medication [7–12], but it often fails when using immobilization by orthoses and anti-inflammatory medications [9, 13].…”

Section: Introductionmentioning

confidence: 99%

“…Conservative management is composed of insoles, orthoses, decreased physical activity, non-weightbearing cast immobilization, and/or nonsteroidal anti-inflammatory medication [7–12], but it often fails when using immobilization by orthoses and anti-inflammatory medications [9, 13]. Indeed, surgery is required in a large number of cases.…”

Section: Introductionmentioning

confidence: 99%

“…Operative treatment should be considered when conservative treatment failed to relieve the symptom [7]. Several operative techniques have been proposed for midfoot pain relief and deformity correction: internal fixation of navicular bone, simple excision of the dorsolateral fragment of the navicular with bone graft [10, 14], percutaneous drilling decompression [12], isolated talonavicular arthrodesis [10, 15, 16], talonavicular-cuneiform (TNC) arthrodesis [7], and double fusion or triple arthrodesis [8]. However, it remains uncertain that which kind of treatment is the best method to treat which type of MWD.…”

Section: Introductionmentioning

confidence: 99%

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Open triple fusion versus TNC arthrodesis in the treatment of Mueller-Weiss disease

Zhang

Qiao

et al. 2017

J Orthop Surg Res

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BackgroundMueller-Weiss disease is a rarely diagnosed deformity where the navicular bone undergoes spontaneous osteonecrosis in adults. Until now, there is no widely accepted operative treatment for this unusual disease. We aimed to compare clinical and radiological outcomes between the open triple fusion and talonavicular-cuneiform arthrodesis for Mueller-Weiss disease of stage 4.MethodsDuring the period from February 2012 to June 2016, 10 patients (11 feet) suffering from Mueller-Weiss disease of stage 4 were treated by the same senior surgeon. Among them, 5 patients (5 feet) were treated with open triple fusion and 5 patients (6 feet) were treated with talonavicular-cuneiform arthrodesis. Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Radiological results were assessed based on the X-ray and CT. Postoperative complications were also recorded.ResultsThere were no significant differences in AOFAS score between the two groups (p = 0.1 > 0.05). For the open triple fusion, the average AOFAS ankle-hindfoot score improved from 30.2 ± 3.27 preoperatively to 79 ± 3.81 at the last follow-up (p = 0.008). And for the talonavicular-cuneiform (TNC) arthrodesis, the average AOFAS ankle-hindfoot score improved from 33.2 ± 5.63 preoperatively to 86.2 ± 3.49 at the last follow-up (p = 0.007).ConclusionsBoth triple fusion and TNC arthrodesis are reasonable methods for the treatment of Mueller-Weiss disease if properly used. It is crucial to use radiological assessment to evaluate the involved joints preoperatively and then chose the appropriate method to treat different patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%