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Occult midtarsal subluxation.

C R Howie, G Hooper, S P Hughes

    Clinical Orthopaedics and Related Research
    |August 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Navicular tuberosity avulsion can indicate occult midtarsal joint subluxation, often missed on initial X-rays. Early non-weight-bearing and casting may improve outcomes for this foot injury.

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    Area of Science:

    • Orthopedic surgery
    • Radiology
    • Sports medicine

    Background:

    • Navicular tuberosity avulsion is a rare foot fracture.
    • Associated injuries, such as calcaneocuboid joint damage, may occur.
    • Occult midtarsal joint subluxation can be challenging to diagnose radiographically.

    Purpose of the Study:

    • To investigate the association between navicular tuberosity avulsion and midtarsal joint injuries.
    • To evaluate the diagnostic challenges and long-term outcomes of these injuries.
    • To suggest appropriate management strategies for patients with these conditions.

    Main Methods:

    • Retrospective review of 14 patients with navicular tuberosity avulsion.
    • Analysis of radiographic findings, particularly focusing on the calcaneocuboid and midtarsal joints.

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  • Clinical follow-up to assess pain, weight-bearing ability, and development of arthritis.

    • Main Results:

    • Seven of 14 patients had associated calcaneocuboid joint damage, suggestive of occult midtarsal joint subluxation.
    • Initial diagnosis was missed in 5 of 7 patients due to radiographic misinterpretation.
    • Prolonged symptoms and degenerative arthritis in the calcaneocuboid joint were common at long-term follow-up.

    Conclusions:

    • Navicular tuberosity avulsion may be a marker for occult midtarsal joint subluxation.
    • Radiographic interpretation is critical for accurate diagnosis.
    • Non-weight-bearing and casting are recommended initial treatments; surgical intervention requires further investigation.