Published online Nov 18, 2020. doi: 10.5312/wjo.v11.i11.507
Peer-review started: February 29, 2020
First decision: April 25, 2020
Revised: May 26, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: November 18, 2020
Processing time: 259 Days and 3.9 Hours
Müller-Weiss disease (MWD) is an idiopathic foot condition characterized by spontaneous tarsal “scaphoiditis” in adults. Frequently bilateral and affecting females during the 4th-6th decades of life, the pathogenesis of MWD remains unclear: It has been traditionally considered a spontaneous osteonecrosis of the navicular. The typical presentation of MWD is a long period of subtle discomfort followed by prolonged standing, atraumatic, disabling pain. Currently, there is no gold standard for the treatment of patients with MWD. Most support initial conservative therapy. Operative treatment should be considered for failure of conservative therapies longer than 6 months. The indication for surgery is severity of symptoms rather than severity of deformities. Operative treatment options include core decompression, internal fixation of the tarsal navicular, open or arthroscopic triple fusion, talo-navicular or talo-navicular-cuneiform arthrodesis, and navicular excision with reconstruction of the medial column.
In this study, we report four patients affected by MWD. Clinical and radiographic assessment, follow-up and treatment are reported.
As it is frequently misdiagnosed, MWD is challenging for orthopedic surgeons. Early diagnosis and effective treatment are mandatory to avoid sequelae.
Core tip: Müller-Weiss is a subtle disease of the foot, rarely described in the literature. This study describes four cases, examines in detail the etiopathogenesis reported in the literature and describes available treatments. We believe that these findings could assist orthopedic surgeons in the successful management of this foot disorder.