Navicular-medial cuneiform tarsal coalition

NewsBot · Mar 24, 2012

Members do not see these Ads. Sign Up.
Isolated navicular-medial cuneiform tarsal coalition revisited: a case report.
Ross JR, Dobbs MB.
J Pediatr Orthop. 2011 Dec;31(8):e85-8.

Tarsal coalitions between the navicular and the cuneiforms occur infrequently when compared with the more common talocalcaneal and calcaneonavicular coalitions. Isolated cases of navicular-medial cuneiform coalitions have only rarely been reported; however, the diagnosis is likely underrecognized. Conservative management should be pursued initially for symptomatic patients, followed by surgical options for unresponsive cases. The few reports available recommend treatment with navicular-medial cuneiform fusions, but long-term follow-up is not available to assess outcome and it remains unclear whether an isolated arthrodesis of the navicular-medial cuneiform joint will in turn lead to differing biomechanics of adjacent joints. We report a case of a patient with an isolated navicular-medial cuneiform coalition, treated with resection and free-fat interposition rather than arthrodesis. To our knowledge, this is the first case of a navicular-medial cuneiform coalition reported in a patient of North American ancestry. At 2 years postoperatively, she is pain-free with all activities and has full range of motion of her ankle and subtalar joints, and full mobility at the navicular-medial cuneiform joint. This unique method provided a successful solution to this difficult situation.
Click to expand...

Admin2 · Mar 24, 2012

Related Threads:
Other threads on tarsal coalitions
Talocalcaneal coalition
Calcaneonavicular coalition
Foot orthoses for tarsal coalition

NewsBot · Jan 24, 2014

Treatment of Naviculo–First Cuneiform Coalition of the Foot
Seong-Eun Byun, Ho Seong Lee, Ji-Yong Ahn, Dong-Kyo Seo,
Foot & Ankle International January 23, 2014

Background: Naviculo–first cuneiform coalition is a rare form of tarsal coalition with few reports. We therefore have analyzed its clinical features and the results of treatment.
Methods: We analyzed 36 feet in 28 patients diagnosed with naviculo–first cuneiform coalition from January 2003 to December 2010. The 28 patients were 10 males and 18 females, with 18 right and 18 left feet, including 8 patients with bilateral coalition. The location and morphological pattern of naviculo–first cuneiform coalition were analyzed radiologically. Symptomatic patients initially received conservative management for 6 months. Six feet of 5 patients were treated operatively, 3 feet by curettage and 3 by fusion.
Results: Eighteen feet had symptoms, while 18 feet without symptoms were diagnosed incidentally. Mean patient age at diagnosis was 34.6 years (range, 10-68 years). The mean age at diagnosis of symptomatic patients was 29.6 years (range, 10-50 years). Coalitions were located mainly in the medioplantar area. There was no bony coalition. Computed tomography or magnetic resonance imaging showed a cystic pattern in 7 patients, an irregular pattern in 4, a combined pattern in 5, and a spur-forming pattern in 1. The mean American Orthopaedic Foot & Ankle Society scores at the last follow-up in patients treated conservatively and operatively were 95.3 (range, 87-100) and 83.5 (range, 70-95), respectively. Among the 5 operated patients, 3 patients (60%) complained of pain, including 2 who received curettage and 1 who developed a nonunion after attempted fusion.
Conclusion: Conservative treatment should be considered over surgery in treating naviculo–first cuneiform coalition.
Click to expand...

blinda · Jan 24, 2014

NewsBot said: ↑

Isolated navicular-medial cuneiform tarsal coalition revisited: a case report.
Ross JR, Dobbs MB.
J Pediatr Orthop. 2011 Dec;31(8):e85-8.
Click to expand...

What conspiracy?

NewsBot · Oct 10, 2015

Bilateral navicular-medial cuneiform synostosis manifesting as medial foot pain: a case report and review of the literature.
Malone JB, Raney EM.
J Pediatr Orthop B. 2015 Oct 8

Isolated navicular-medial cuneiform tarsal coalition is a rare condition. Very few case reports exist, with limited treatment recommendations. We present a case of an 11-year-old with bilateral isolated osseous navicular-medial cuneiform tarsal coalition. The patient was treated with bilateral coalition excision and soft tissue interposition, with excellent results at 2 years of follow-up. The current case is unusual in being an osseous coalition rather than the more commonly seen cartilaginous or fibrous condition. In addition, this case is uncommon as being in a patient of European rather than Asian descent.
Click to expand...

NewsBot · Oct 19, 2015

Naviculocuneiform Coalition: Case Reports of Two Sibling Soccer Players
Amol Saxena, DPM, FACFAS, Magali Fournier, DPM, FACFAS
JFAS; Article in Press

Tarsal coalitions are an abnormal union between 2 tarsal bones. They occur most commonly between the calcaneus and talus or the calcaneus and navicular but can also arise from other joints in the foot. Isolated cases of coalitions between the medial cuneiform and navicular are extremely rare, and only a few cases have been reported. Treatment recommendations are, therefore, sparse, and no long-term follow-up data have been reported. We present the case of 2 sisters, each diagnosed with a symptomatic naviculocuneiform coalition. To our knowledge, this is the first reported case in 2 first-degree relatives. Both sisters were involved in sports and presented with pain during physical activities. After conservative treatment had failed, they were both treated successfully with surgical excision of the coalition and arthrodiastasis, followed by a progressive return to activities. At the last follow-up examination at 5 and 3 years postoperatively, they remained pain free and fully involved in college soccer, making excision of a naviculocuneiform coalition with arthrodiastasis a valid treatment in the young athletic population.
Click to expand...

NewsBot · Aug 13, 2016

A case report on the coalition of cuneiforms with
Navicula and second metatarsal
Patra S, Nayak S, Mohapatra C
International Journal of Applied Research 2016; 2(1): 282-283

Introduction: Tarsal coalition is a well-defined entity in paediatric as well as adult population. Tarsal
coalition is an abnormal union between two or more bones which leads to restriction or limitation of the
subtalar joint. The incidence of tarsal coalition is only 1-2%, out of which 90% affect the talocalcaneal
or the calcaneonavicular bones.
Aim: This case report will be beneficial for anatomists, surgeons, orthopedicians, radiologists and
podiatrists as it is the rarest of the rare case ever found in the literature.
Observations: In this case the lateral cuneiform is fused with the second metatarsal anteriorly and
navicular posteriorly. We also found that the three cuneiforms are fused to the navicular bone. All the
above coalitions are osseous and complete.
Conclusion: This case report will throw light on the possibility of occurrence of such rare cases which
may be beneficial to the Surgeons, Anatomists, Radiologists, Podiatrists and Orthopedicians.
Click to expand...

NewsBot · Dec 20, 2016

Anatomic Description of the Naviculocuneiform Articulation
Kevin Renner et al
The Journal of Foot and Ankle Surgery
Volume 56, Issue 1, January–February 2017, Pages 19–21

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.
Click to expand...

Stanley · Jan 2, 2017

I had a case of this. A six year old girl followed for 20 years. Surprisingly no symptoms related to it.

NewsBot · Nov 1, 2017

Rare Cause of Foot Pain: Osseous Coalition of the Third Metatarsal and Lateral Cuneiform.
Abda RB et al
Mil Med. 2017 May;182(5):e1814-e1815. doi: 10.7205/MILMED-D-16-00240.

Tarsometatarsal osseous coalition is extremely rare. Herein, we present a case of osseous coalition between the base of the third metatarsal and the lateral cuneiform. The patient is a 38-year-old male who presented with an acute episode of foot pain following strenuous activity. Radiographs of the left foot demonstrated an osseous coalition between the third metatarsal base and the lateral cuneiform. Tarsal coalition is a congenital defect that results when adjacent tarsals fail to separate during embryonic development. According to the literature, total osseous coalition is less common than cartilaginous coalition. This case serves as only the second known documented case of osseous coalition between the third metatarsal and the lateral cuneiform, with the first case published in an orthopedic journal. To our knowledge, no case of third metatarsal-lateral cuneiform coalition has been published in the literature otherwise. The intent of this publication is to add to the database of tarsometatarsal coalition cases with a specific emphasis on bony coalition between the third metatarsal and lateral cuneiform.
Click to expand...

NewsBot · Oct 3, 2018

CT Features of Naviculocuneiform Coalitions: Correlation with Patient Symptoms
Kyung Ah Chun, MD, PhD, Jin Soo Suh, MD, PhD
AOFAS Annual Meeting 2018 1

Introduction/Purpose: The purpose of our study was to evaluate and compare the CT features in patients with symptomatic
and asymptomatic naviculocuneiform coalition
Methods: We retrospectively reviewed the CT images of 37 naviculocuneiform coalitions in 26 patients (mean age 30 years). The
26 patients were 12 males and 14 females, with 19 right and 18 left feet, including 11 patients with bilateral coalition. The CT
images were analyzed with regard to irregular articular surface, subchondral sclerosis, subchondral cyst, bone spur, joint space
distance, loose body and bony fusion. The size of subchondral cyst was measured. The location and extent of joint involvement
was also evaluated. CT features were compared between symptomatic and asymptomatic feet.
Results: There were 20 feet (54%) in symptomatic group and 17 feet (46%) in asymptomatic group. The mean size of the
subchondral cyst was 6.3 mm in the symptomatic group and 2.5 mm in the asymptomatic group (statistically significant). Bone
spurs were significantly more common in the symptomatic group (11 of 20 feet) than in the asymptomatic group (2 of 17 feet) (p
< 0.01). All 8 feet received operative treatment had subchondral cysts (mean size 6.7 mm) or bone spurs. Irregular articular
surfaces were seen in all feet. Subchondral sclerosis, joint space distance, loose body, location and extent of joint involvement did
not differ statistically significantly between two groups.
Conclusion: Because of a statistically significant overlap of CT features, only large subchondral cysts and bone spurs can be more
commonly detected with CT in the symptomatic feet compared to the asymptomatic feet, and may indicate aggressive treatment
in patients with naviculocuneiform coalition.
Click to expand...

NewsBot · Nov 7, 2020

Radiographic characteristics and outcomes of simple resection for naviculo-medial cuneiform coalition in adults
JaeyoungKim et al
Foot and Ankle Surgery; 5 November 2020

Highlights
•The radiographic characteristics of the naviculo-medial cuneiform (NC) coalition and outcomes of resection in adults were assessed.
•NC coalitions were limited to the plantar-medial aspect of the joint with no degenerative changes at the residual joint space.
•Alignment of a medial longitudinal arch, including NC joint, maintained after coalition resection at final follow-up.
•There was no evidence of radiographic recurrence and clinical scores improved significantly.
Click to expand...

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.
Click to expand...

NewsBot · Apr 8, 2021

Medial Column Foot Pain due to Isolated First Tarsometatarsal Joint Coalition: Case Report and Surgical Technique
Ahmed Aljawadi, Amirul Islam, Noman Jahangir, Noman Niazi & Anand Pillai
SN Comprehensive Clinical Medicine (2021)

Tarsal coalition is a rare condition; only two cases had been reported showing first tarsometatarsal joint coalition. We presented a case of a 22-year-old man who had a medial column left foot pain started 5 years prior to diagnosis. Patient was diagnosed with left first tarsometatarsal joint coalition. Following consultation, the patient decided to undergo surgery. Surgical management included debridement of the coalition and reconstruction of articular surface with Chondrotissue. Outcomes were assessed using the Manchester Oxford Foot Questionnaire (MOXFQ) and Foot and Ankle Ability Measure (both Activity of daily living subscale [FAAM ADL] and Sport subscale [FAAM Sport]). Postoperative follow-up continued for 6 months. The overall MOXFQ score had improved from 84 to 43.75%. FAAM ADL scores improved from 39.3 to 91.66%. FAAM sport scores had improved from 0% preoperatively to 33.37% at 6 months postoperatively. Patient had a significant improvement in all aspect of activities of daily living, sport, pain and social interaction (as measured by MOXFQ, FAAM ADL/Sports).
Click to expand...

NewsBot · May 10, 2023

A Rare Case of Naviculo-medial Cuneiform Coalition Treated with Naviculo-medial Cuneiform Arthrodesis: A Case Report
Kaylem M Feeney 1 2, Stephen R Kearns 2 3
JBJS Case Connect. 2023 Apr 24;13(2

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.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

blinda MVP

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Stanley Well-Known Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Burning Sensation in area of Base of 1st met, medial cuneiform and navicular

Navicular cunieform (medial) fusion

47 Year Old Female - Shart Shooting Pain medial ankle, navicular area, upon initial stance.

Navicular/Medial cunieform stress fracture or abductor hallucis tendinitis?

Navicular anatomy

Possible Accessory Navicular Fracture?

The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot

Share This Page