Inferomedial (Subsustentacular) Dislocation of the Navicular: A Case Report (original) (raw)
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Total dislocations of the navicular: are they ever isolated injuries?
The Journal of Bone and Joint Surgery, 1999
I solated dislocations of the navicular are rare injuries; we present our experience of six cases in which the navicular was dislocated without fracture. All patients had complex injuries, with considerable disruption of the midfoot. Five patients had open reduction and stabilisation with Kirschner wires. One developed subluxation and deformity of the midfoot because of inadequate stabilisation of the lateral column, and there was one patient with ischaemic necrosis. We believe that the navicular cannot dislocate in isolation because of the rigid bony supports around it; there has to be significant disruption of both longitudinal columns of the foot.
An isolated dorso-medial dislocation of navicular bone: A case report
Journal of Clinical Orthopaedics and Trauma, 2014
An isolated dislocation of tarsal navicular is extremely rare injury. Usually it is associated with fracture of navicular itself or other tarsal bones of foot along with disruption of medial or lateral column of foot. Mechanism of injury is complex but usually a severe abduction force is required to produce such injury in a planter flexed foot. A 30 year old male presented with isolated navicular dislocation. Management required open reduction and fixation with k-wires. These injuries have specific complications including avascular necrosis of navicular and post-traumatic arthritis.
Naviculocuneiform Dislocations Treated With Immediate Arthrodesis: A Report of 2 Cases
The Journal of Foot and Ankle Surgery, 2005
The authors report on 2 patients who sustained naviculocuneiform dislocations and intercuneiform diastasis, and who were treated with immediate arthrodesis of the midfoot complex. Injury patterns in both cases involved damage to the medial facet of the distal navicular articular surface, separation of the first and second cuneiforms, and an unstable first ray. At the 15- and 18-month follow-up, respectively, both patients attained a stable, solid fusion with maintenance of the medial longitudinal architecture. Both patients returned to their preinjury activity levels with no disability.
Trauma Cases and Reviews: Isolated Dislocation of the Tarsal Navicular without Fracture: Case Report
Isolated dislocation of the tarsal navicular bone is a rare lesion. The mechanism of this specific trauma is still not well to understood, due to the strength needed in different ways and directions for its occurrence, in a complex way. Few cases of an isolated dislocation of the navicular reported in medical literature, and there is little information about complications how the patients evolve after years of postoperative. The authors present a case of a woman, 39-years-old, who suffered a complete dislocation of the talus-navicular of her left foot, due to a fall. After initial k-wire fixation, the patient presented herself 6 weeks later with chondrolysis of the tarsus articulations and submitted to selective arthrodesis of talus navicular and cuneiform medial-talus-navicular (TN + CTN). Having passed 13 years of post-surgery, the patient presents a good clinical evolution and articulation functionality. It concluded that the isolated navicular dislocation, even though promptly and adequately reduced and stabilized, may develop complications, such as chondrolysis, and the correct handling by selective arthrodesis enables a satisfactory functional and clinical outcome.
Isolated dorsal dislocation of the tarsal naviculum
Indian Journal of Orthopaedics, 2015
Isolated dislocation of the tarsal naviculum is an unusual injury, scarcely reported in the literature. The naviculum is surrounded by the rigid bony and ligamentous support hence fracture dislocation is more common than isolated dislocation. The mechanism and treatment options remain unclear. In this case report, we describe a 31 year old man who sustained an isolated dorsal dislocation of the left tarsal naviculum, without fracture, when he was involved in a motor vehicle collision. The reported mechanism of the dislocation is a hyper plantar flexion force applied to the midfoot, resulting in a transient disruption of the ligamentous support of the naviculum bone, with dorsal displacement of the bone. The patient was treated with open reduction and Krischner-wire fixation of the navicular after the failure of closed reduction. The wires were removed after 6 weeks postoperatively. Physiotherapy for stiffness and midfoot pain was recommended for 2 months. At 6 months postoperatively, limping, midfoot pain and weakness were reported, no X-ray abnormalities were found. The patient returned to his obvious activities with a normal range of motion.
Trauma Cases and Reviews
Introduction: Tarsal navicular bone dislocation is a rare condition which can lead to long term disability, mainly due to difficulties to obtain an anatomical reduction. Only few cases have been reported. Case presentation: We report a case of a 21-year-old Cameroonian male who was admitted to the emergency department after a road traffic accident. The physical examination reveals a patient unable to bear weight, with a painful swelling of the antero-medial dorsal region of the right foot, without neurovascular deficits or another lesion. The plain X-ray and the CT scan of the right foot and ankle reveal a medial dislocation of the talonavicular joint without associated fracture. An open reduction was done and two Kirschner wires of 2 mm were place to maintain the reduction. The patient was discharge after five days with an ankle/foot X-ray showing successful reduction of the talonavicular joint. He was reviewed at one and twelve weeks later with no complain and a normal X-ray. Conclusion: Tarsal navicular bone dislocation is a rare condition which can lead to long term disability. Even in resources constraint settings, a CT-scan should be done when available, in addition to radiography to rule out an associated lesion which can be missed by the X-ray, and to plan the surgical approach.
Cases Journal, 2009
Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was in normal limits and the patient could still work as a builder. However, he complained for occasionally mild pain due to the development of post-traumatic arthritis in subtalar and ankle joints. Our search in literature revealed that conservative treatment of all the successfully reduced and minimally displaced subtalar fracture-dislocations has given superior results compared to surgical management. However, even in cases with no or slight fracture displacement, avascular necrosis of the talus or arthritis of the surrounding joints can compromise the final functional outcome.
Closed Navicular Dislocation - Management and Outcome - A Case Report
Acta Scientific Orthopaedics
Navicular dislocations are a rare injury and pose a challenge for the surgeon in the emergency department and the operating room. We report a case of a 41-years old male patient who presented with completely closed dislocation of navicular and was treated by open reduction and fixation of the naviculocuneiform and calcaneocuboid joints. At 12 months follow up, the patient had no deficits in activities of daily living.