title: Failure of Internal Fixation for Painful Bipartite Navicular in Two Adolescent Soccer Players: A Report of Two Cases.
abstract: Bipartite navicular bone is an uncommon condition that can cause midfoot pain in children and adolescents. No treatment methods, other than conservative management, have been reported. We report the cases of 2 adolescent soccer players who underwent internal fixation of the painful bipartite fragments, resulting in nonunion. After failure of conservative management, the patients underwent surgery. Curettage of the junction between the 2 bone fragments was performed, and autologous cancellous bone was grafted. Next, the fragments were fixed with variable-threaded screws. Bone union of the bipartite fragments was once achieved on computed tomography in both cases at 3 and 5 months after surgery, respectively. However, separation of the fragment occurred in both cases after the patients had returned to sports. Although the patients were able to return to sports activities, they still had mild midfoot pain 3 and 2 years after surgery, respectively. Internal fixation using screws and an autologous bone graft for painful bipartite navicular bone in adolescent athletes is not recommended, and other surgeries should be considered to achieve bony union.
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. Electronic address: y-satoshi@mvb.biglobe.ne.jp.
authors: Satoshi
authors: S
authors: Yamaguchi
authors: Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
authors: Hisateru
authors: H
authors: Niki
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Ryuichiro
authors: R
authors: Akagi
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Yohei
authors: Y
authors: Yamamoto
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Takahisa
authors: T
authors: Sasho
mesh_terms: D000293:Adolescent; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D012916:Soccer / Q000293:injuries*; D013639:Tarsal Bones / Q000293:injuries*; D017211:Treatment Failure
keywords: Mueller-Weiss disease; foot; osteosynthesis; stress fracture; tarsal navicular