Medial naviculocuneiform fracture-dislocations: A report of two cases

Abstract

Medial naviculocuneiform fracture-dislocation – classified as a type B1 Lisfranc injury according to the Hardcastle classification modified by Myerson, or perhaps more accurately termed a ‘Lisfranc-like medial column injury extending to the naviculocuneiform joint’ – is an uncommon pathology. Available evidence is limited, with only a few cases reported in the literature. We present two cases of medial naviculocuneiform fracture-dislocation treated with different surgical techniques. The first case presented acutely and was managed with rigid fixation using cannulated screws. In contrast, the second case underwent primary arthrodesis due to a prolonged time since the injury and articular damage. Both patients were followed clinically and radiographically for 12 months. At the final follow-up, the acute case demonstrated an American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score of 70/100 and a visual analog scale (VAS) score of 4/10, but with early osteoarthritic changes. In contrast, the delayed presentation case achieved an AOFAS midfoot score of 85/100 and a VAS score of 2/10. Level of Evidence IV; Case Report