Calcaneocuboid and Naviculocuneiform Dislocation: An Unusual Injury of the Midfoot

Abstract

Introduction. Midfoot dislocations are rare traumatic injuries. The best known patterns involve the Lisfranc and Chopart joints, although some other types have been described. Dislocations that occur at the level of the naviculocuneiform and calcaneocuboid joints simultaneously represent a very rare configuration of dislocation. Case Presentation. A 34-year-old man sustained a crush injury to his left foot causing a complete dislocation through the naviculocuneiform and calcaneocuboid joints. Immediate closed reduction and percutaneous pinning were performed, followed by open reduction and stabilization of both joints two weeks later. Anatomical reduction was obtained, and the clinical outcome remained satisfactory 10 months after surgery. Discussion. Anatomical reduction is essential to obtain favorable outcomes in traumatic midfoot injuries. An unusual pattern of midfoot dislocation can be treated according to the same principles as those for classical Lisfranc or Chopart injuries.

Open fracture dislocation of the calcaneocuboid and naviculocuneiform joints: A case report

“…Fixation was applied to prevent the occurrence of any future deformity such as pes planus, which occurred with Genena, Abouelela and Fadel's patient, who also developed midfoot arthritis [10] . For the ORIF stage of treatment, we utilized a hybrid technique by using plates and k-wires; this technique is similar to the one used by Kummer, Crevoisier and Eudier [8] . A plate was used in the midfoot to stabilize the NC joint since this is the highest stress area during gait.…”

“…Plates achieve this because they are stiffer, have a higher failure threshold, and have been shown to provide firm fixation without causing further articular damage in comparison to transarticular screws [6] , [14] . The rationale behind using a tarsometatarsal (TMT) plate instead of a bridge plate or small locking plate was that a TMT plate would provide a more anatomical fit thereby maximizing joint stability [6] , [8] . Additionally, adequate anatomical reduction of the NC joint is vital due to the involvement of the medial column in preserving the foot arch [6] .…”

“… No functional outcome recorded Dhole et al [7] One case presented with fracture-dislocation of CC and NC joints with anterior calcaneus process fracture. ORIF with K-wires 24 months AOFAS 95 Kummer, Crevoisier, and Eudier [8] One case presented with CC and NC joints dislocation associated with fractures of the medial cuneiform, anterior calcaneus process and fibula. Closed reduction and percutaneous pinning.…”

“…In particular, combined fracture and dislocation of the calcaneocuboid (CC) and naviculocuneiform (NC) joints is a very rare injury; therefore, it is under-reported [3] . The uncommonness of this injury and its relation to high-energy trauma are attributable to the robust bony support and firm ligamentous attachments surrounding the CC and NC joints [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . Combined fracture and dislocation of the CC and NC joints were reported by eight studies previously [4] , [5] , [6] , [7] , [8] , [9] , [10] .…”

“…The uncommonness of this injury and its relation to high-energy trauma are attributable to the robust bony support and firm ligamentous attachments surrounding the CC and NC joints [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . Combined fracture and dislocation of the CC and NC joints were reported by eight studies previously [4] , [5] , [6] , [7] , [8] , [9] , [10] . However, only one study has reported an associated open fracture [6] .…”