Navicular and cuboid fractures can be complex and difficult to treat. Depending on the mechanism of injury, diagnosis of such fractures is not always possible with conventional radiographs due to the irregularity and overlap of the midfoot bones. Advanced imaging is indicated if a fracture is of high suspicion or to further characterize a displaced fracture. Cuboid and navicular fractures can occur in isolation but are often associated with other midfoot injuries due to their anatomic relationships. Typically, nondisplaced fractures can be treated conservatively, whereas displaced fractures require surgical intervention to prevent future complications.

Dorsomedial fracture dislocations of the tarsal navicular are extremely rare injuries which commonly occur secondary to high energy, complex multidirectional forces involving an abduction force to a pronated and plantar-flexed foot. A 44-year-old female presented in the emergency room following a motor vehicle accident with a dorsomedial fracture dislocation of her navicular. Management required acute fusion of the talonavicular joint. There are few reports in the literature discussing the treating, outcomes, and complications of these injuries. Our report represents one method of treating these rare injuries with a favorable outcome.

Kohler\'s disease is characterized by osteochondritis of the navicular bone due to various factors like the lack of blood supply and late ossification of the bone. In particular, it is a disease of the pediatric age group, which has male preponderance. It may present with bony pain unilaterally or, at times, be asymptomatic and diagnosed accidentally. Clinical presentation and radiological investigations are the mainstay of diagnosis. This self-limiting condition requires only symptomatic conservative management. A surgical approach is not yet indicated. One such case of bilateral Kohler\'s disease is presented in this report. Here, we discuss the disease\'s presentation, examination, treatment, and prognosis.

UNASSIGNED: Medial aspect of foot is unexplored due to its complex anatomy. Masterknot of Henry is an important landmark in this region, which plays a key role during tendon transfer procedures especially in those involving the flexor hallucis longus and flexor digitorum longus. We aim to determine the exact anatomical location of masterknot of Henry with respect to the bony prominences of the medial aspect of the foot and compare these measurements to the length of the foot.
UNASSIGNED: Twenty cadaveric below-knee specimens were dissected. Structures on the medial side of the foot were exposed. Distance of the masterknot of Henry from surrounding bony landmarks was measured. Depth of the masterknot from skin of the plantar aspect was also measured. Means of all parameters were calculated. Relation between measurements and the foot length was determined using correlation and regression analysis. P value of less than 0.05 was considered significant.
UNASSIGNED: Distance of masterknot of Henry from navicular tuberosity was found to be fairly constant of 19.965 mm. Foot length was found to be correlating with the distance between masterknot of Henry and medial malleolus, navicular tuberosity and its depth from the skin.
UNASSIGNED: Navicular tuberosity can be considered an important surface landmark for the location of masterknot of Henry. Correlation of length of the feet with various measurements helps to find the masterknot considering the foot length to be an important variable. Good knowledge of surface anatomy leads to shorter operating time and less morbidity during procedures involving the flexor hallucis longus and flexor digitorum longus.

The morphological adaptations of euprimates have been linked to their origin and early evolution in an arboreal environment. However, the ancestral and early locomotor repertoire of this group remains contentious. Although some tarsal bones like the astragalus and the calcaneus have been thoroughly studied, the navicular remains poorly studied despite its potential implications for foot mobility. Here, we evaluate early euprimate locomotion by assessing the shape of the navicular-an important component of the midtarsal region of the foot-using three-dimensional geometric morphometrics in relation to quantified locomotor repertoire in a wide data set of extant primates. We also reconstruct the locomotor repertoire of representatives of the major early primate lineages with a novel phylogenetically informed discriminant analysis and characterize the changes that occurred in the navicular during the archaic primate-euprimate transition. To do so, we included in our study an extensive sample of naviculars (36 specimens) belonging to different species of adapiforms, omomyiforms, and plesiadapiforms. Our results indicate that navicular shape embeds a strong functional signal, allowing us to infer the type of locomotion of extinct primates. We demonstrate that early euprimates displayed a diverse locomotor behavior, although they did not reach the level of specialization of some living forms. Finally, we show that the navicular bone experienced substantial reorganization throughout the archaic primate-euprimate transition, supporting the major functional role of the tarsus during early primate evolution. This study demonstrates that navicular shape can be used as a reliable proxy for primate locomotor behavior. In addition, it sheds light on the diverse locomotor behavior of early primates as well as on the archaic primate-euprimate transition, which involved profound morphological changes within the tarsus, including the navicular bone.

OBJECTIVE: Müller-Weiss disease (MWD) is a rare anomaly of the tarsal scaphoid. Maceira and Rochera proposed the most commonly accepted etiopathogenic theory, in which dysplastic, mechanical, and socioeconomic environmental factors would be involved. The aim is to describe the clinical and sociodemographic characteristics of patients with MWD in our setting, corroborate their association with the socioeconomic factors previously described, estimate the influence of other factors involved in the development of MWD, and describe the treatment carried out.
METHODS: Retrospective study of 60 patients diagnosed with MWD in 2 tertiary hospitals of Valencia (Spain) between 2010 and 2021.
RESULTS: Sixty patients were included, 21 (35.0%) men and 39 (65.0%) women. In 29 (47.5%) cases, the disease was bilateral. The mean age of onset of symptomatology was 41.9±20.3 years. During childhood, 36 (60.0%) patients suffered migratory movements, and 26 (43.3%) had dental problems. The mean age of onset was 14.6±4.5 years. Thirty-five (58.3%) cases were treated orthopedically versus 25 (41.7%) treated surgically, 11 (18.3%) by calcaneal osteotomy, and 14 (23.3%) with arthrodesis.
CONCLUSIONS: As in the series of Maceira and Rochera, we found a higher prevalence of MWD among those born around the Spanish Civil War and the period of massive migratory movements that occurred in the fifth decade of the 20th century. Treatment is still not well established.

OBJECTIVE: Müller-Weiss disease (MWD) is a rare anomaly of the tarsal scaphoid. Maceira and Rochera proposed the most commonly accepted etiopathogenic theory, in which dysplastic, mechanical, and socioeconomic environmental factors would be involved. The aim is to describe the clinical and sociodemographic characteristics of patients with MWD in our setting, corroborate their association with the socioeconomic factors previously described, estimate the influence of other factors involved in the development of MWD, and describe the treatment carried out.
METHODS: Retrospective study of 60 patients diagnosed with MWD in 2 tertiary hospitals of Valencia (Spain) between 2010 and 2021.
RESULTS: Sixty patients were included, 21 (35.0%) men and 39 (65.0%) women. In 29 (47.5%) cases, the disease was bilateral. The mean age of onset of symptomatology was 41.9±20.3 years. During childhood, 36 (60.0%) patients suffered migratory movements, and 26 (43.3%) had dental problems. The mean age of onset was 14.6±4.5 years. Thirty-five (58.3%) cases were treated orthopedically versus 25 (41.7%) treated surgically, 11 (18.3%) by calcaneal osteotomy, and 14 (23.3%) with arthrodesis.
CONCLUSIONS: As in the series of Maceira and Rochera, we found a higher prevalence of MWD among those born around the Spanish Civil War and the period of massive migratory movements that occurred in the fifth decade of the 20th century. Treatment is still not well established.

UNASSIGNED: Long recovery time, large scar, postoperative swelling and pain are possible side effects of open reduction internal fixation (ORIF) for tarsal navicular fractures. Early exercise instruction is made possible by the use of an intraoperative robot-assisted percutaneous invasive closed reduction internal fixation. The goal of the trial was to determine whether percutaneous screw internal fixation with robot assistance might be used to treat navicular fractures.
UNASSIGNED: 27 patients with navicular fractures had surgical treatment between June 2019 and December 2021. Of those, 20 instances were treated with ORIF, while 7 cases had robot-assisted percutaneous screw internal fixation. At the final follow-up, the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score and the visual analogue scale (VAS) score were compared to determine outcomes and function.
UNASSIGNED: Follow-up was obtained in all 27 patients after surgery, with a mean follow-up time of 21.81 months, ranging from 15 to 29 months . In the 7 instances of robot-assisted group, percutaneous guide wire insertion and screw placement only needed one attempt and the depth and position of the implant were both satisfactory. In the ORIF group, there were two patients who sustained cutaneous nerve injuries. The AOFAS score and the VAS score of the group receiving robot-assisted navigation percutaneous screw fixation were 92.25 ± 2.22 and 0.75 ± 0.25 respectively at the last follow-up, while 82.25 ± 7.15 and 0.50 ± 0.29 were the respective values for the ORIF group.
UNASSIGNED: Intraoperative robot-assisted percutaneous closed reduction internal fixation for tarsal navicular fractures can accomplish exact localization of fracture site, reduce soft tissue damage and operative time. According to current view, this method offers fewer complications, a faster recovery after surgery, and more patient satisfaction.

UNASSIGNED: To use the computed tomography (CT) attenuation of the foot and ankle bones for opportunistic screening for osteoporosis.
UNASSIGNED: Retrospective study of 163 consecutive patients from a tertiary care academic center who underwent CT scans of the foot or ankle and dual-energy X-ray absorptiometry (DXA) within 1 year of each other. Volumetric segmentation of each bone of the foot and ankle was done in 3D Slicer to obtain the mean CT attenuation. Pearson\'s correlations were used to correlate the CT attenuations with each other and with DXA measurements. Support vector machines (SVM) with various kernels and principal components analysis (PCA) were used to predict osteoporosis and osteopenia/osteoporosis in training/validation and test datasets.
UNASSIGNED: CT attenuation measurements at the talus, calcaneus, navicular, cuboid, and cuneiforms were correlated with each other and positively correlated with BMD T-scores at the L1-4 lumbar spine, hip, and femoral neck; however, there was no significant correlation with the L1-4 trabecular bone scores. A CT attenuation threshold of 143.2 Hounsfield units (HU) of the calcaneus was best for detection of osteoporosis in the training/validation dataset. SVMs with radial basis function (RBF) kernels were significantly better than the PCA model and the calcaneus for predicting osteoporosis in the test dataset.
UNASSIGNED: Opportunistic screening for osteoporosis is possible using the CT attenuation of the foot and ankle bones. SVMs with RBF using all bones is more accurate than the CT attenuation of the calcaneus.

BACKGROUND: Resection of tarsal coalitions provides good patient satisfaction scores, reduced pain, and improved long-term function in both athletic and non-athletic populations. This study aimed to determine when athletic patients undergoing resection of a tarsal coalition were able to return to their desired activity, and whether they experienced a decreased desired activity level (DDA).
METHODS: Data on a total of 78 patients who underwent 97 tarsal coalition resections (49 talocalcaneal coalitions, 47 calcaneo-navicular, 14 cuboid-navicular, and three cuneo-navicular; some patients had more than one coalition) operated between January 2001 and June 2020 were prospectively collected. To subjectively assess outcomes, the Roles and Maudsley score (RM) was utilized.
RESULTS: At an average follow-up from the index procedure of 33.6 ± 41.5 months, return to activity for the entire cohort was 18.3 ± 9.6 weeks. Post-RM was 1.3 ± 0.6.
CONCLUSIONS: Surgical excision of tarsal coalitions produced favorable results, with most patients able to return to their desired activity level.
METHODS: IV.