Planning for Surgery in Müller-Weiss Disease

As with any surgery, especially major, preoperative planning plays a very important role in success of the surgical procedure. Carefully select the joints to be fused by clinical assessment of pain and tenderness at the various perinavicular jointsPerinavicular joints, confirming with diagnostic injections as necessary. Review the radiographs and SPECT-CTSPECT-CT to determine amount of necrotic bone and remaining bone stock. All required instrumentation and implants should be available in the operating room, including allograftAllograft bone and other biologicsBiologics. This author prefers autologous tricortical iliac crest bone graftBone graft to replace large bony defects. Aim to reduce any medial talonavicular subluxationTalonavicular subluxation. Reduction of the navicularNavicular from its displaced plantar and medial location to the apex of the medial arch will automatically restore medial column length, correct the medial arch and midfoot abductionMidfoot abduction. Good joint preparation and stable fixation will ensure a favourable milieu for union.