Mueller-Weiss Treated With Pan-Navicular Fusion

Chronic midfoot pain that has failed orthotic treatment

Advanced Mueller-Weiss disease with pain or deformity

Fragmentation of the navicular

Peri-navicular arthritis

Is the patient suffering from arthritic joints, deformity, or both?

Evaluate hindfoot and midfoot alignment. In advanced cases of Mueller-Weiss disease, there can be pes planus and hindfoot varus, which occurs as the navicular collapses and the talar head moves laterally.

A weight-bearing anteroposterior radiograph of the foot demonstrates advanced Mueller-Weiss disease, with collapse of the lateral navicular ( Fig. 26.1 ).

A weight-bearing lateral radiograph of the foot demonstrates fragmentation of the navicular ( Fig. 26.1B ).

A computed tomography scan of the foot demonstrates sclerosis and fragmentation of the navicular ( Fig. 26.2 ).

Magnetic resonance imaging demonstrates pan-navicular arthritis with avascular fragments. The advanced naviculo-cuneiform arthritis is only evident on magnetic resonance imaging ( Fig. 26.3 ).

Isolated talonavicular fusion

Double fusion

Triple arthrodesis

None of these options address the naviculo-cuneiform arthritic changes or preserve medial length

See Chapter 25 .