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Feeney KM, Kearns SR. A Rare Case of Naviculo-medial Cuneiform Coalition Treated with Naviculo-medial Cuneiform Arthrodesis: A Case Report. JBJS Case Connect 2023; 13:01709767-202306000-00020. [PMID: 37093982 DOI: 10.2106/jbjs.cc.22.00712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
CASE A 19-year-old woman developed spontaneous onset of right midfoot pain in the absence of trauma. Conservative management including orthotics and steroid injection reduced, but did not resolve, pain. Weight-bearing x-ray and CT confirmed naviculo-medial cuneiform coalition. After failure of conservative treatment, the patient elected to undergo right naviculo-medial cuneiform arthrodesis and returned to normal activity without pain postoperatively and at 4-year follow-up. CONCLUSION Naviculo-medial cuneiform coalition is a rare source of midfoot pain, but should be considered as a differential diagnosis. This case suggests that naviculo-medial cuneiform arthrodesis can successfully resolve symptoms if conservative measures fail.
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Affiliation(s)
- Kaylem M Feeney
- University of Limerick School of Medicine, Faculty of Education and Health Services, Castletroy, Co. Limerick, Ireland
- Departments of Orthopaedics, Bon Secours Hospital, Galway, Co. Galway, Ireland
| | - Stephen R Kearns
- Departments of Orthopaedics, Bon Secours Hospital, Galway, Co. Galway, Ireland
- Department of Trauma & Orthopaedics, Galway University Hospital, Co. Galway, Ireland
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Kim J, Kim JB, Day J, Seilern Und Aspang J, Lee WC. Radiographic characteristics and outcomes of simple resection for naviculo-medial cuneiform coalition in adults. Foot Ankle Surg 2021; 27:820-826. [PMID: 33176995 DOI: 10.1016/j.fas.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/03/2020] [Accepted: 10/27/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed to report the outcomes of coalition resection in adults with naviculo-medial cuneiform (NC) coalition. METHODS Seventeen adults (20 feet) who underwent NC coalition resection were identified. The location and morphology of coalitions and five angular parameters, including medial arch sag angle (MASA), were assessed on weightbearing radiographs. Pre- and postoperative visual analogue scale and foot function index were evaluated for clinical outcomes. RESULTS Most feet (19 out of 20) had a coalition at the plantar-medial aspect, and there was no radiographic evidence of residual NC joint space compromise. There was no radiographic evidence of medial arch sag (MASA, p = 0.749) or recurrence at the final follow-up (21.7 months, range 12 to 48). Clinical scores improved significantly in all patients. CONCLUSIONS Resection of NC coalition in adults can be successful and provides an option to arthrodesis when conservative treatments have failed.
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Affiliation(s)
- Jaeyoung Kim
- Hospital for Special Surgery, New York, NY 10021, USA
| | - Ji-Beom Kim
- Seoul Foot and Ankle Center, Dubalo Orthopaedic Clinic, Seoul, Republic of Korea
| | - Jonathan Day
- Hospital for Special Surgery, New York, NY 10021, USA; Georgetown University School of Medicine, Washington, DC, USA
| | - Jesse Seilern Und Aspang
- Hospital for Special Surgery, New York, NY 10021, USA; Medical University of Vienna, 1090 Vienna, Austria
| | - Woo-Chun Lee
- Seoul Foot and Ankle Center, Dubalo Orthopaedic Clinic, Seoul, Republic of Korea.
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Johnson AJ, Gokcen E. Tarsal Coalition of the Cuneiforms in a Young Athlete: A Case Report. JBJS Case Connect 2021; 11:e19.00404. [PMID: 33502134 DOI: 10.2106/jbjs.cc.19.00404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Tarsal coalitions are relatively common, but there are no reports of cuneiform-to cuneiform coalition in the English language literature. The authors present a case of medial-to-intermediate cuneiform coalition in a young female track athlete. Previous nonoperative treatments had been unsuccessful. Coalition release and medial-intermediate cuneiform arthrodesis enabled her to return initially to full athletic participation without pain, but she had return of pain that persists despite removal of hardware. CONCLUSION Medial-intermediate cuneiform coalition is rare. Surgery in this patient provided a short period of pain-free athletic participation, but long-term outcomes are not proven, and further research is needed.
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Affiliation(s)
- Alexander J Johnson
- Department of Orthopaedics and Sports Medicine, Temple University Hospital, Philadelphia, Pennsylvania
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Choi JY, Chun KA, Lee DJ, Cho ST, Suh JS. Determining the factors influencing the symptoms related to naviculo-medial cuneiform coalition. J Orthop Surg (Hong Kong) 2020; 27:2309499019832719. [PMID: 30827191 DOI: 10.1177/2309499019832719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE We aimed to determine the factors that influence the symptoms of naviculo-cuneiform (NC) coalition using radiography and computed tomography (CT). METHODS We retrospectively reviewed the radiographic and CT findings of 37 NC coalition cases. The existence of a large pit (depth >3 mm), irregular articular surface, joint space narrowing, dorsal bony spur, subchondral sclerosis, multiple subchondral bony cysts, and intra-articular loose body were evaluated on radiographs or CT. The size of the largest subchondral bony cyst was also measured using CT. All cases were divided into two subgroups according to the symptoms. Fisher's exact test was used to distinguish the factors influencing the symptoms. RESULTS Twenty-three and fourteen feet were enrolled into the symptomatic and asymptomatic groups, respectively. The rates of the large pit on either radiograph (47.83 vs. 21.43%) or CT (65.22 vs. 28.57%) were significantly different between both groups ( p = 0.001). The mean size of the largest subchondral bony cyst on CT was also significantly greater in the symptomatic group (4.25 vs. 1.53 mm, p = 0.005). CONCLUSION A large deep pit and huge subchondral bony cyst on the radiograph or CT can be related to symptoms for the patient with NC coalition. A CT is highly recommended for a more accurate evaluation in patients with NC coalition.
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Affiliation(s)
- Jun Young Choi
- 1 Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea
| | - Kyung Ah Chun
- 2 Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea
| | - Dong Joo Lee
- 1 Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea
| | - Sung Tan Cho
- 1 Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea
| | - Jin Soo Suh
- 1 Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea
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Alatassi R, Alsiddiky A, Alajlan A, Koaban S. Nonsyndromic Massive Tarsal and Tarsometatarsal Coalitions in a Young Female. J Foot Ankle Surg 2019; 58:581-585. [PMID: 30902491 DOI: 10.1053/j.jfas.2018.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Indexed: 02/03/2023]
Abstract
Tarsal coalition is an abnormal connection between 2 or more tarsal bones, with the most common sites being between the talus and the calcaneus and between the navicular and the calcaneus. The occurrence of multiple and massive tarsal coalitions is rare. We describe a rare case of nonsyndromic bilateral tarsal coalition involving most of the tarsal bones and extending to the metatarsal bones in a 4-year-old female. The condition was not painful and did not affect her gait. The main concern was the abnormal shape of her feet. Tarsal coalition can occur as an isolated anomaly or in association with other congenital disorders, usually presenting around the age of 12 years. The coexistence of nonsyndromic bilateral multiple tarsal coalitions is seldom reported. Regardless of the presentation, treatment is not indicated in cases of asymptomatic tarsal coalition. Our patient had a unique presentation of tarsal coalition, involving both the tarsal and tarsometatarsal bones. To our knowledge, this is the first report of this type of presentation.
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Affiliation(s)
- Raheef Alatassi
- Orthopedic Surgeon, Department of Orthopedic Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.
| | - Abdulmonem Alsiddiky
- Research Chair of Spinal Deformities and Professor of Pediatric Orthopedic Surgery, Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alajlan
- Orthopedic Surgeon, Department of Orthopedic Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Saeed Koaban
- Orthopedic Surgery Consultant, Department of Orthopedic Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
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Babu NS, Bowlby MA. Combined Osseous Medial Cuneonavicular Coalition and Nonosseous Naviculocuboid Coalition Presenting as First Metatarsophalangeal Joint Pain. J Am Podiatr Med Assoc 2018; 108:434-436. [PMID: 34670343 DOI: 10.7547/17-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Tarsal coalitions of the lesser tarsus are relatively rare congenital anomalies. A case report of a 54-year-old man with an osseous medial cuneonavicular coalition and a nonosseous naviculocuboid coalition that presented as first metatarsophalangeal joint pain is described.
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Affiliation(s)
- Nina S Babu
- Department of Podiatry, Kaiser Foundation Hospital, Santa Rosa, CA
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Abstract
Surgical interventions at the naviculocuneiform joint are not uncommon to deal with various pathologies of the joint and correction of different foot deformities. To minimize the soft tissue dissection, naviculocuneiform arthroscopy has been described. The purpose of this Technical Note is to report the details of this arthroscopic approach.
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Affiliation(s)
- Tun Hing Lui
- Address correspondence to Tun Hing Lui, M.B.B.S.(H.K.), F.R.C.S.(Edin.), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui New Territories, Hong Kong SAR 999077, China.
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Renner K, McAlister JE, Galli MM, Hyer CF. Anatomic Description of the Naviculocuneiform Articulation. J Foot Ankle Surg 2017; 56:19-21. [PMID: 27989339 DOI: 10.1053/j.jfas.2016.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Indexed: 02/03/2023]
Abstract
The naviculocuneiform articulation is composed of the navicular proximally and the 3 cuneiforms distally. It is not uncommon to perform surgical interventions at this joint for multiple pathologic foot etiologies. To date, no detailed anatomic measurement is available for each cuneiform articulation on the navicular. The purpose of the present study was to present an anatomic description of this complex joint to aid in better surgical understanding and improve surgical outcomes. Ten fresh, frozen, and thawed below-the-knee cadaveric specimens were used for anatomic dissection of the navicular and associated cuneiforms. The height and width were recorded across the largest span of the entire navicular-cuneiform joint complex and each facet. The mean navicular height and width was 19.9 mm and 34.7 mm, respectively. The medial cuneiform facet mean height and width was 19.9 mm and 15.8 mm, respectively. The intermediate cuneiform facet mean height and width was 20.4 mm and 16.9 mm, respectively. The lateral cuneiform facet mean height and width was 17.5 mm and 14.7 mm, respectively. A detailed description of this joint complex will aid foot and ankle surgeons in screw placement and surgical decision-making when performing complex medial column fusions. Advanced 3-dimensional weightbearing computed tomography would give us a better idea of the motion that occurs within this complex joint.
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Affiliation(s)
- Kevin Renner
- Postgraduate Year 2 Resident, OhioHealth Grant Medical Center, Columbus, OH
| | | | | | - Christopher F Hyer
- Fellowship Director, Attending Physician, Orthopedic Foot & Ankle Center, Westerville, OH.
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