Enfermedad de Müller Weiss
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Keywords:
Necrosis avascular, Koehler’s disease, Müller Weiss syndrome, navicular, osteochondrosisAbstract
The Müller Weiss disease (MWD) is a peculiar deformity of the adult tarsal navicular. The etiology is not fully understood yet. Numerous theories have been proposed: primary osteonecrosis, osteochondritis, congenital malformation, trauma or biomechanical causes, and unusual changes in Köhler's disease. The most accepted theory, proposed by Maceira, combines delayed ossification of the scaphoid with a non-uniform distribution of compressive forces. It is a rare disease, although it is believed to be more frequent than reported, since in many talonavicular osteoarthritis, an unnoticed MWD is the cause. It occurs in adults between 40-60 years, mostly women, and often affects both feet. Patients have chronic pain in the dorsum of the midfoot, which can make walking unbearable. The diagnosis is made with the clinical examination plus a radiographic set, where a compression in the lateral half of the scaphoid can be noticed, which decreases its size and takes the classical coma shaped form. There is no specific treatment for MWD, first establishing a conservative treatment is usually effective in most cases and if its not, multiple surgery options are available.