Salvage arthrodesis for fracture-dislocation of the cuneonavicular and calcaneocuboid joints: a case report.
We present a 22-year-old man with dislocation of both the calcaneocuboid and cuneonavicular joints and fractures of the calcaneum and navicular of the right foot. The joints were reduced with percutaneous Kirschner wires, but the disrupted dorsal cuneonavicular ligaments were left unrepaired. Reduction was suboptimal and the joints were subluxed resulting in disabling arthralgia. Six months later, he underwent salvage arthrodesis of the subluxed calcaneocuboid and cuneonavicular joints. At 24-month follow-up, the patient had returned to work and remained pain-free when walking, with good fusion of both joints. Early anatomic reduction, stable fixation, and ligament reconstruction are essential for a good outcome. Arthrodesis is indicated when subluxation and posttraumatic arthritis are present. Primary arthrodesis is a viable option for severe midfoot fracture-dislocations, because it facilitates rehabilitation and functional recovery, and obviates the need for a secondary arthrodesis should arthritis arise.
Kang
G C
GC
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Rikhraj
I S
IS
D000328:Adult; D001174:Arthrodesis; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D011859:Radiography; D013639:Tarsal Bones / Q000293:injuries*; D013640:Tarsal Joints