Treatment for Bipartite Navicular and Brailsford’s Osteochondritis

Conditions labelled as bipartite navicularBipartite navicular and severe forms of Brailsford’s osteochondritisBrailsford’s osteochondritis represent Maceira stage V of Müller-Weiss diseaseMüller-Weiss disease, whereby the lateral portion of the navicularNavicular has fragmented, the small lateral navicular fragment extruded dorsally, the larger medial fragment subluxed medially and the talar head articulating directly with the lateral cuneiform bone forming the talocuneiform articulationTalocuneiform articulation. Open reduction and internal fixationInternal fixation of the lateral navicular fragment to the parent bone has been attempted with mostly poor outcomes, as anticipated by Fernández de Retana et al. who warned that the lateral navicularNavicular fragment is far too small for bony union. Others have performed talonavicular arthrodesisTalonavicular arthrodesis and either excised the dorsally extruded lateral navicular fragment or fused it to the lateral cuneiform bone to supposedly preserve motion through the so-called crank-shaped arthrodesisCrank-shaped arthrodesis.