PMC6374815_01
Frontal and lateral radiographs show increased radiodensity, dorsal protrusion, and collapse of the lateral portion of the tarsal navicular.
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Sclerotic collapse was also noted at the lateral aspect of the tarsal navicular (Figure 1).
Axial and sagittal CT scans show diffuse sclerosis of the tarsal navicular.
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Computed tomography (CT) scans showed diffuse sclerosis and marginal irregularities of the tarsal navicular (Figure 2).
Sagittal MRI shows low signal-intensity areas on both T1-weighted images (a) and T2-weighted images (b) in the marrow of the tarsal navicular. Gd-based MRI (c) shows increased uptake in the peripheral tarsal navicular.
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Gd-based MRI showed increased uptake in the peripheral tarsal navicular, which was representative of hypervascular areas (Figure 3).
Postoperative radiograph shows fixation using LCP-DRP with 6 2.4 mm locking screws.
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Arthrodesis was performed using an LCP Distal Radius Plate (SYNTHES) with 6 2.4 mm locking screws from the medial aspect of the foot (Figure 4).
Histopathologic findings show diffuse empty lacunae, suggesting osteonecrosis.
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Histopathologic findings showed diffuse empty lacunae without any infection, consistent with avascular necrosis (Figure 5).
After 5 years of follow-up, radiographs show insufficient fusion of the talonavicular joint.
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A radiograph taken 5 years after surgery showed nonunion with mild osteoarthrosis of the talonavicular joint (Figure 6).
PMC6374815_02
Frontal and lateral radiographs show increased radiodensity, dorsal protrusion, and fragmentation of the tarsal navicular.
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Radiographs showed increased radiodensity, dorsal protrusion, and fragmentation of the tarsal navicular (Figure 7).
Axial and sagittal CT scans confirm fragmentation of the tarsal navicular and a cystic lesion in the talus.
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CT scans showed a segmented tarsal navicular and cystic lesions with sclerotic changes in the neck of the talus (Figure 8).
MRI shows low signal-intensity areas on T1-weighted images (a) and T2-weighted images (b) in the marrow of the tarsal navicular.
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MRI showed low signal-intensity areas on T1-weighted images and T2-weighted images in the marrow of the tarsal navicular, which suggested osteonecrosis (Figure 9).
(a) Arthrodeses of the talonavicular and naviculocuneiform joints using CSLP-VA. (b) Postoperative radiograph shows fixation using CSLP-VA with 4 4.0 mm locking screws.
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Primary fixation was performed using CSLP-VA (SYNTHES) with 4 4.0 mm locking screws from the medial aspect of the foot (Figure 10).
Histopathologic findings show normal osteocytes and empty lacunae.
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(a) CT scan 6 months after surgery shows sufficient bone union fusion at the talonavicular and naviculocuneiform joints. (b) After 5 years of follow-up, the radiograph shows sufficient fusion.
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A radiograph taken 6 months after surgery showed sufficient bone union (Figure 12(a)). Four years after surgery, her radiograph showed complete fusion at the talonavicular and naviculocuneiform joints (Figure 12(b)).