Treatment of naviculo-first cuneiform coalition of the foot.
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.


CONCLUSIONS
Conservative treatment should be considered over surgery in treating naviculo-first cuneiform coalition.


METHODS
Level III, comparative case series.
Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.
Seong-Eun
SE
Byun
Ho Seong
HS
Lee
Ji-Yong
JY
Ahn
Dong-Kyo
DK
Seo
Jeong Ho
JH
Seo
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005528:Foot / Q000601:surgery*; D005532:Foot Deformities, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013580:Synostosis / Q000175:diagnosis / Q000601:surgery*; D013639:Tarsal Bones / Q000002:abnormalities* / Q000601:surgery; D055815:Young Adult
first naviculo–cuneiform coalition; naviculo–first cuneiform coalition; tarsal coalition