Müller-Weiss disease: Four case reports

Abstract

BACKGROUND Müller-Weiss disease (MWD) is an idiopathic foot condition characterized by spontaneous tarsal “scaphoiditis” in adults. Frequently bilateral and affecting females during the 4 th -6 th decades of life, the pathogenesis of MWD remains unclear: It has been traditionally considered a spontaneous osteonecrosis of the navicular. The typical presentation of MWD is a long period of subtle discomfort followed by prolonged standing, atraumatic, disabling pain. Currently, there is no gold standard for the treatment of patients with MWD. Most support initial conservative therapy. Operative treatment should be considered for failure of conservative therapies longer than 6 months. The indication for surgery is severity of symptoms rather than severity of deformities. Operative treatment options include core decompression, internal fixation of the tarsal navicular, open or arthroscopic triple fusion, talo-navicular or talo-navicular-cuneiform arthrodesis, and navicular excision with reconstruction of the medial column. CASE SUMMARY In this study, we report four patients affected by MWD. Clinical and radiographic assessment, follow-up and treatment are reported. CONCLUSION As it is frequently misdiagnosed, MWD is challenging for orthopedic surgeons. Early diagnosis and effective treatment are mandatory to avoid sequelae.

Kohler's Disease Case Report: Treatment with Regenerative Distraction Arthroplasty Technology

“…This appeared to lead to a satisfactory resolution of the patient symptoms. Medial column fusion does lead to a significant increase in the stiffness of the foot [10]. In the last 7 years the senior author has been treating some cases of ankle, hindfoot and midfoot arthritis and cartilage injury with distraction arthroplasty.…”

“…The treatments are normally applied when the disease has progressed to Stage 4 [9]. Under the right conditions, both triple fusion and TNC arthrodesis have proven to be suitable methods for the treatment of Mueller-Weiss disease [10].…”