AI Article Synopsis
- A 17-year-old boy with chronic navicular osteonecrosis underwent a complex 6-month surgery involving open reduction, internal fixation, and bone grafting to treat his condition.
- Post-surgery, he achieved full painless weight-bearing by 4 months, with successful healing of chronic fractures and incorporation of grafts.
- The innovative use of vascularized bone grafting allowed for preservation of the talonavicular joint, improved patient outcomes, and avoided early fusion surgery.
Article Abstract
Case: A 17-year-old boy with a history of chronic bilateral navicular osteonecrosis with fragmentation was treated with 6-month staged bilateral open reduction and internal fixation of tarsal navicular with debridement of the necrotic bone and ipsilateral medial femoral condyle vascularized bone grafting.
Conclusion: The patient progressed to full painless weight-bearing on each extremity by 4 months postoperatively with osseous union of both chronic fracture sites and incorporation of vascularized bone grafts. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were improved from preoperative levels at 6 months from each operation. This patient's atypical presentation of a rare disease was successfully treated with the utilization of vascularized bone grafting to salvage the tarsal navicular and preserve the talonavicular joint, enabling return of function and avoidance of early arthrodesis procedure.
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| http://dx.doi.org/10.2106/JBJS.CC.20.00010 | DOI Listing |
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