Müller-Weiss Disease: Past, Present and Future Directions

A century later, much remains to be discovered about Müller-Weiss diseaseMüller-Weiss disease. Although an index minus metatarsal formulaIndex-minus metatarsal formula plays an important role, other aetiological factors are yet to be identified. It is not known when disease actually begins for lack of earlier radiographs that predate disease detection. Geographical variations such as early-onset disease in Egypt, different Müller-Weissoid and reverse Müller-Weissoid patterns in Spain and Northern Ireland, exist which require elucidation. The catchy term paradoxical pes planus varusParadoxical pes planus varus only applies when both flatfoot and heel varusHeel varus are present. WBCT may reveal why heels do not always varize while the talar head displaces laterally. Results of pedobarography should be reported according to the Wong Groups. Future research should look into possibility of preserving some or all of the naviculocuneiform joints, the role of shortening metatarsal osteotomiesMetatarsal shortening osteotomy and how to proceed once fracture occurs at the lateral navicular, be it undisplaced or displaced. Proposed novel surgical procedures such as navicular replacementNavicular replacement require close scrutiny. A combination of the Wong Groups and Maceira stages may provide a common platform for disease reporting and measuring outcomes of nonoperative treatmentNonoperative treatment and various surgical procedures in controlled fashion. Only then can gold standards of treatment be clearly defined.