Vascularized Scapular Free Bone Graft after Nonunion of a Tarsal Navicular Stress Fracture: A Case Report

Toren, Adam J.; Hahn, David B.; Brown, William C.; Stone, Paul A.; Ng, Alan

doi:10.1053/j.jfas.2012.12.010

Cited by 12 publications

(5 citation statements)

References 12 publications

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“…Partial weight bearing treatment and displacement were associated with nonunion. Delayed union, should it occur, may be treated with either further immobilisation, particularly in the context of a failure of treatment by partial weight bearing, or by open reduction and internal fixation [31,32]. Time to return to sport does not appear to be accelerated by surgery [33].…”

Section: Navicularmentioning

confidence: 99%

Stress fractures of the foot and ankle

Welck,

Hayes,

Pastides

et al. 2017

Injury

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Section: Navicularmentioning

confidence: 99%

Stress fractures of the foot and ankle

Welck,

Hayes,

Pastides

et al. 2017

Injury

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“…Tuberosity and displaced body fractures are treated surgically while others are treated conservatively [5]. Navicular stress fracture is common among athletes and may have devastating consequences including avascular necrosis [67]. …”

Section: Introductionmentioning

confidence: 99%

Vascular foramina of navicular bone: a morphometric study

et al. 2017

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The navicular bone is supplied by more than one artery. The knowledge about the vascular foramina is important to understand the pathogenesis and management of navicular fractures. The objective of the present study is to analyze the morphology and morphometry of vascular foramina of dried human navicular bone in Indian population. The study was carried out by using 100 navicular bones (50 right and 50 left) collected from our institute and other medical institutes in and around Puducherry. The bones were macroscopically studied for vascular foramina with respect to its location, number, size, and shape. The data collected were statistically analyzed. The vascular foramina were present on dorsal, plantar, medial, and lateral surfaces of navicular bone. Kruskal-Wallis test followed by series of Mann-Whitney test for post hoc analysis showed the number of nutrient foramina observed on dorsal surface were significantly greater than those observed on the plantar (U=2,755, P =0.001), medial (U=43, P =0.001), and lateral (U=626.5, P =0.001) surfaces of the navicle. About 97.6% of foramina were circular and 2.5% were oval in appearance. About 96.7% of vascular foramina were <1 mm in size and 3.3% were ≥1 mm in size. Spearman's rank correlation coefficient done showed a strong, positive correlation between vascular foramina of <1 mm size and circular shape, which was statistically significant ( r s =0.981, P =0.001). We believe the present study has provided additional information on the vascular foramina of navicular bone and useful to surgeons in foot surgeries.

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“…5 Different bone flaps have been used to treat osteonecrosis associated with repeated talonavicular arthrodesis failures, including fibula, scapular, iliac crest, and femoral condyle flaps. [6][7][8] Of these, the fibula flap exhibits the highest versatility in the reconstruction of bone defects in various areas of the body, and it is of particular interest in areas with a weak blood supply, such as the foot and ankle. 7 However, little has been published on the use of fibula flaps when reconstructing failed arthrodeses in the midfoot.…”

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confidence: 99%

Use of fibula flaps to treat persistent talonavicular nonunion: A report of three cases

et al. 2016

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Owing to the limited blood supply in the midfoot, multiple arthrodesis attempts in midfood joints may result in severe osteonecrosis, leading to a difficult scenario for bone reconstruction. This article describes the use of fibula flaps (two free and one pedicled flap) to reconstruct bone defects in three cases of persistent nonunion in midfoot joints. Before admission, all patients (aged 32-56 years old) had undergone multiple arthrodesis attempts (range 3-4) aimed at treating joint diseases associated with flatfoot or Müller-Weiss syndrome. All inserted flaps were stable, and bone fusion was confirmed by X-ray examination at month 4. After the follow-up period (range 1-4 years), all patients showed normal, painless gait. No foot deformities or further complications were observed. Our report suggests that fibula flap transfer may be a good alternative for treating persistent nonunion in midfoot joints involving bone loss, and may prevent the osteonecrosis associated with limited blood supply. © 2016 Wiley Periodicals, Inc. Microsurgery 36:430-434, 2016.

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Vascularized Scapular Free Bone Graft after Nonunion of a Tarsal Navicular Stress Fracture: A Case Report

Cited by 12 publications

References 12 publications

Stress fractures of the foot and ankle

Stress fractures of the foot and ankle

Vascular foramina of navicular bone: a morphometric study

Use of fibula flaps to treat persistent talonavicular nonunion: A report of three cases

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