An Atraumatic Calcaneocuboid Joint Instability - Technique of Surgical Reconstruction: A Case Report

Most calcaneocuboïd joint (CCJ) subluxations are traumatic, secondary to a high-energy flexion-supination mechanism. We describe here a case of atraumatic chronic subluxation of the CCJ which is a rare, difficult to diagnose condition. Moreover, we describe a surgical technique using a peroneus brevis autograft hemi-tendon, which has not been yet published in the literature.

A 58-year-old woman presented initially for a painful right hallux. A careful clinical examination revealed tenderness of the lateral side of the foot. The intensity of the pain had been increasing for the past 5 years, due to repetitive movements of pronosupination of the mid-foot. As it turned out, this repetitive movement was caused by the daily use of a floor scrubber for her work as a janitor, resulting in a chronic CCJ instability. The foot computed tomography (CT) scan confirmed the CCJ subluxation with an osseous avulsion on calcaneal apophysis, proof of ligamentous injury.

We present a rare case of atraumatic CCJ subluxation, due to overuse activity. Calcaneocuboid joint instability is difficult to diagnose. Anamnesis is critical to understand which pathologic movements are responsible for joint instability. CT scan is helpful. As a treatment, we used an innovative surgical technique similar to the hemi-Castaing procedure used for chronic ankle instability. This technique, which has not been yet described in the literature, is simple, non-invasive, and reconstructs the dorsal calcaneocuboid ligament and part of the bifurcate ligament.