Flatfoot in Müller-Weiss syndrome: a case series

Area of Science:

• Orthopedics
• Foot and Ankle Surgery
• Radiology

Background:

• Müller-Weiss syndrome is a rare condition causing spontaneous osteonecrosis of the navicular bone in adults.
• This study addresses the uncommon presentation of Müller-Weiss syndrome with concomitant flatfoot deformity.
• The natural history and management of this combined condition remain controversial.

Purpose of the Study:

• To describe the surgical management and outcomes of patients with Müller-Weiss syndrome and flatfoot deformity.
• To evaluate the effectiveness of surgical fusion in correcting the deformity and restoring function.
• To provide insights for surgeons selecting operative procedures for this specific patient group.

Main Methods:

• A retrospective review of six patients (five women, one man; average age 54 years) diagnosed with Müller-Weiss syndrome and flatfoot.
• Failed conservative treatments including physical therapy and NSAIDs were noted.
• Surgical interventions included talonavicular joint arthrodesis or triple arthrodesis, with outcomes assessed using the AOFAS ankle-hindfoot scale.

Main Results:

• All six patients underwent surgical fusion (talonavicular or triple arthrodesis).
• Pre-operative AOFAS scores averaged 63.0, improving to 89.8 post-operatively.
• Bony fusion was achieved in all cases, indicating successful surgical intervention.

Conclusions:

• Surgical treatment of Müller-Weiss syndrome with associated flatfoot deformity can lead to favorable outcomes.
• Arthrodesis procedures effectively correct deformities, alleviate pain, and restore foot function.
• The choice of surgical technique should consider the presence of posterior tibial tendon dysfunction.