Non-osseous coalition of the medial cuneiform-first metatarsal joint: a case report

Multiple Tarsometatarsal Coalitions: A Case Report

Tarsometatarsal coalitions have rarely been reported in published literature. The few reported cases presented with varying degrees of pain. Here, we describe the case of a 16-year-old female with multiple tarsometatarsal coalitions, the first of its kind in the reported literature. Descriptions in anthropology literature suggest that these lesions might be more common than previously thought and, in some circumstances, can become symptomatic enough to warrant intervention.

Tarsal Coalition of the Cuneiforms in a Young Athlete: A Case Report

CASE

Tarsal coalitions are relatively common, but there are no reports of cuneiform-to cuneiform coalition in the English language literature. The authors present a case of medial-to-intermediate cuneiform coalition in a young female track athlete. Previous nonoperative treatments had been unsuccessful. Coalition release and medial-intermediate cuneiform arthrodesis enabled her to return initially to full athletic participation without pain, but she had return of pain that persists despite removal of hardware.

CONCLUSION

Medial-intermediate cuneiform coalition is rare. Surgery in this patient provided a short period of pain-free athletic participation, but long-term outcomes are not proven, and further research is needed.

Bilateral navicular-medial cuneiform synostosis manifesting as medial foot pain: a case report and review of the literature

Isolated navicular-medial cuneiform tarsal coalition is a rare condition. Very few case reports exist, with limited treatment recommendations. We present a case of an 11-year-old with bilateral isolated osseous navicular-medial cuneiform tarsal coalition. The patient was treated with bilateral coalition excision and soft tissue interposition, with excellent results at 2 years of follow-up. The current case is unusual in being an osseous coalition rather than the more commonly seen cartilaginous or fibrous condition. In addition, this case is uncommon as being in a patient of European rather than Asian descent.

Nonosseous Tarsal Coalition of the Lateral Cuneocuboid Joint: A Case Report

We describe a rare case of a nonosseous coalition of the lateral cuneocuboid joint with peroneal spasm that we successfully treated with resection. A 60-year-old female had been experiencing constant pain in her right foot, particularly when walking and going up and down stairs. The pain had been present for approximately 1 year after she had experienced a minor injury. Her right ankle showed plantar flexion restrictions (right 20° and left 40°) and was held in an antalgic valgus position. Sudden passive plantar flexion produced pain behind the lateral malleolus of the right ankle. Tenderness was detected in the right peroneus brevis tendon and the right sinus tarsi. On plain radiographs, the oblique view showed an irregularity in the articular surface of the lateral cuneocuboid joint in both feet. On computed tomography images, there was no osseous continuation in the lateral cuneocuboid joint, indicative of a nonosseous bridge between the lateral cuneiform and the cuboid. The nonosseous coalition between the lateral cuneiform and the cuboid was resected and the trabecular surfaces and cortical margins covered with a thin film of bone wax. The patient's recovery was unremarkable, and 1 year after surgery, she was able to walk without pain and was able to perform her usual activities and job.

Isolated Fifth Metatarsocuboid Coalition: A Case Report

Isolated tarsometatarsal coalitions are extremely rare, and the previous 5 documented cases involved the first and third metatarsocuneiform joints. We report the case of a 69-year-old female with symptomatic fifth metatarsocuboid coalition associated with ipsilateral varus-type ankle osteoarthritis and instability. The patient was successfully treated by arthrodesis of the fifth metatarsocuboid joint, resection of the hypertrophied tuberosity of the fifth metatarsal, advancement of the peroneus brevis tendon, opening wedge distal tibial osteotomy, and calcaneal displacement osteotomy. After 1 year, 6 months, she was able to walk well, although she complained of minor discomfort under the fifth metatarsal base, which resolved with the use of protective padding. Radiographs at this stage confirmed consolidation of both the arthrodesis and the osteotomy sites. Although isolated fifth metatarsocuboid coalition is less likely to be encountered than other tarsal coalitions, it can sometimes be painful enough to necessitate surgery.

Botulinum Toxin Type A Injection Combined With Cast Immobilization for Treating Recurrent Peroneal Spastic Flatfoot Without Bone Coalitions: A Case Report and Review of the Literature

Peroneal spastic flatfoot is an uncommon condition. It often presents as a rigid and usually painful valgus deformity in the hindfoot with peroneal muscles spasms. Although tarsal coalition is an important cause, a few patients have not undergone bone coalitions. We describe a 27-year-old female who experienced recurrent peroneal spastic flatfoot after an injury. She was treated successfully with a combination of botulinum toxin type A and immobilization of the foot in a neutral position with a cast. After 3 years, the condition had not recurred, and she was pain free and walked normally, with no increase in muscle tone. This unique treatment could be of potential use to treat many patients with such conditions.