Treatment of Spontaneous Osteonecrosis of the Tarsal Navicular With a Free Medial Femoral Condyle Vascularized Bone Graft

Author:

Levinson Howard1234,Miller Kyle J.1234,Adams Samuel B.1234,Parekh Selene G.1234

Affiliation:

1. Division of Plastic and Reconstructive Surgery, Departments of Surgery and Pathology (HL, KJM), Duke University Medical Center, Durham, North Carolina

2. Department of Orthopaedic Surgery (SBA), Duke University Medical Center, Durham, North Carolina

3. North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery (SGP), Duke University Medical Center, Durham, North Carolina

4. Fuqua School of Business, Duke University, Durham, North Carolina (SGP)

Abstract

Adult-onset spontaneous osteonecrosis of the tarsal navicular joint, or Mueller–Weiss syndrome (MWS), is an uncommon debilitating disease characterized by a painful clinical course with progressive midfoot deformity. Treatment options include nonoperative management and/or operative intervention, including percutaneous decompression of the navicular bone, stabilization of existing structures, and cancellous bone grafting from the tibia or iliac crest. To our knowledge, there have been no reported cases of treatment of MWS with a vascularized bone graft. We report an unusual case of unilateral MWS in a 25-year-old male who failed nonoperative therapy and was successfully treated with a novel operative approach using debridement followed by a free medial femoral condyle vascularized bone graft. At 18-month follow-up, the patient demonstrated an excellent outcome with return to previous level of function, including work-related and recreational activities. Level of Evidence: Therapeutic, Level IV: Case study

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Podiatry,Surgery

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1. Successful Midfoot Reconstruction in Müller-Weiss Disease Using a Reverse Fibular Flap: A Case Report and Literature Review;Cureus;2024-09-02

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