A Case Report of Bilateral Navicular Osteonecrosis Successfully Treated with Medial Femoral Condyle Vascularized Autografts: A Case Report

Ivan J. Zapolsky; Christopher R. Gajewski; Matthew Webb; Keith L. Wapner; L. Scott Levin

doi:10.2106/JBJS.CC.20.00010

A Case Report of Bilateral Navicular Osteonecrosis Successfully Treated with Medial Femoral Condyle Vascularized Autografts: A Case Report

Ivan J. Zapolsky
, Christopher R. Gajewski
, Matthew Webb
, Keith L. Wapner
, L. Scott Levin

Orthopaedics

University of Pennsylvania

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Case:A 17-year-old boy with a history of chronic bilateral navicular osteonecrosis with fragmentation was treated with 6-month staged bilateral open reduction and internal fixation of tarsal navicular with debridement of the necrotic bone and ipsilateral medial femoral condyle vascularized bone grafting.Conclusion:The patient progressed to full painless weight-bearing on each extremity by 4 months postoperatively with osseous union of both chronic fracture sites and incorporation of vascularized bone grafts. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were improved from preoperative levels at 6 months from each operation. This patient's atypical presentation of a rare disease was successfully treated with the utilization of vascularized bone grafting to salvage the tarsal navicular and preserve the talonavicular joint, enabling return of function and avoidance of early arthrodesis procedure.

Original language	English
Pages (from-to)	1-5
Number of pages	5
Journal	JBJS Case Connector
Volume	10
Issue number	3
DOIs	https://doi.org/10.2106/JBJS.CC.20.00010
State	Published - Jul 2020

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title = "A Case Report of Bilateral Navicular Osteonecrosis Successfully Treated with Medial Femoral Condyle Vascularized Autografts: A Case Report",

abstract = "Case:A 17-year-old boy with a history of chronic bilateral navicular osteonecrosis with fragmentation was treated with 6-month staged bilateral open reduction and internal fixation of tarsal navicular with debridement of the necrotic bone and ipsilateral medial femoral condyle vascularized bone grafting.Conclusion:The patient progressed to full painless weight-bearing on each extremity by 4 months postoperatively with osseous union of both chronic fracture sites and incorporation of vascularized bone grafts. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were improved from preoperative levels at 6 months from each operation. This patient's atypical presentation of a rare disease was successfully treated with the utilization of vascularized bone grafting to salvage the tarsal navicular and preserve the talonavicular joint, enabling return of function and avoidance of early arthrodesis procedure.",

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T1 - A Case Report of Bilateral Navicular Osteonecrosis Successfully Treated with Medial Femoral Condyle Vascularized Autografts

T2 - A Case Report

AU - Zapolsky, Ivan J.

AU - Gajewski, Christopher R.

AU - Webb, Matthew

AU - Wapner, Keith L.

AU - Levin, L. Scott

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Y1 - 2020/7

N2 - Case:A 17-year-old boy with a history of chronic bilateral navicular osteonecrosis with fragmentation was treated with 6-month staged bilateral open reduction and internal fixation of tarsal navicular with debridement of the necrotic bone and ipsilateral medial femoral condyle vascularized bone grafting.Conclusion:The patient progressed to full painless weight-bearing on each extremity by 4 months postoperatively with osseous union of both chronic fracture sites and incorporation of vascularized bone grafts. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were improved from preoperative levels at 6 months from each operation. This patient's atypical presentation of a rare disease was successfully treated with the utilization of vascularized bone grafting to salvage the tarsal navicular and preserve the talonavicular joint, enabling return of function and avoidance of early arthrodesis procedure.

AB - Case:A 17-year-old boy with a history of chronic bilateral navicular osteonecrosis with fragmentation was treated with 6-month staged bilateral open reduction and internal fixation of tarsal navicular with debridement of the necrotic bone and ipsilateral medial femoral condyle vascularized bone grafting.Conclusion:The patient progressed to full painless weight-bearing on each extremity by 4 months postoperatively with osseous union of both chronic fracture sites and incorporation of vascularized bone grafts. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were improved from preoperative levels at 6 months from each operation. This patient's atypical presentation of a rare disease was successfully treated with the utilization of vascularized bone grafting to salvage the tarsal navicular and preserve the talonavicular joint, enabling return of function and avoidance of early arthrodesis procedure.

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A Case Report of Bilateral Navicular Osteonecrosis Successfully Treated with Medial Femoral Condyle Vascularized Autografts: A Case Report

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