Light Bulb Procedure for the Treatment of Tarsal Navicular Osteonecrosis After Failed Percutaneous Decompression: A Case Report
Journal
Journal of Foot and Ankle Surgery
Journal Volume
58
Journal Issue
1
Pages
187-191
Date Issued
2019
Author(s)
Abstract
Tarsal navicular osteonecrosis in adults is a rare condition with unclear etiology, and the optimal treatment has not been established. Here we report a case of tarsal navicular osteonecrosis with a complete course of treatment and comprehensive imaging studies starting at an early stage. A 37-year-old female diagnosed with tarsal navicular osteonecrosis was first treated with percutaneous decompression, but her symptoms persisted postoperatively. The tarsal navicular showed no further collapse, but follow-up magnetic resonance imaging (MRI) at 6 months postoperatively revealed persistent osteonecrotic changes. Debridement of the necrotic bone with preservation of the cortical shell and bone substitute packing for the defect (light bulb procedure) were performed. The symptoms resolved by 3 months postoperatively, and the patient could return to work. At a 6-year follow-up visit, the patient was free of symptoms, and MRI showed remodeling of the tarsal navicular without further collapse. ? 2018
Subjects
4; autologous graft; bone substitute; karyorrhexis; percutaneous decompression; sclerotic bone; transillumination
SDGs
Other Subjects
calcium sulfate; adult; American Orthopaedic Foot and Ankle Society midfoot scale score; ankle pain; arthroscopic surgery; Article; bone lesion; bone necrosis; case report; cast application; clinical article; conservative treatment; female; fluoroscopy; foot disease; foot pain; foot surgery; human; intraoperative period; light bulb procedure; musculoskeletal system parameters; nuclear magnetic resonance imaging; percutaneous decompression; postoperative period; scoring system; talus osteochondral lesion; tarsal navicular osteonecrosis; weight bearing; bone necrosis; bone prosthesis; debridement; decompression surgery; diagnostic imaging; drug therapy; pathology; tarsal bone; Adult; Bone Substitutes; Debridement; Decompression, Surgical; Female; Humans; Magnetic Resonance Imaging; Osteonecrosis; Tarsal Bones
Publisher
Academic Press Inc.
Type
journal article