Altnagelvin Hospital.
Foot Ankle Int. 2012 Apr;33(4):275-81. doi: 10.3113/FAI.2012.0275.
Müller-Weiss disease (MWD) is an uncommon condition of unclear etiology, characterized by compression of the lateral aspect of the tarsal navicular bone. It presents with chronic mid and hindfoot pain, mostly in middle-aged females. It does not represent persistence of Kohler's disease, which is self-limiting and resolves completely in childhood.
A total of 12 patients with 19 affected feet, seven of whom had bilateral involvement, presented to a single foot and ankle surgeon over a 10-year period. Diagnosis of MWD was based on radiographic appearances demonstrating compression of the lateral part of the navicular. Affected feet were graded using Maceira classification.
The cohort comprised four males and eight females with a mean age of 57.9 years. Only one patient had previously been a manual worker. Mean duration of symptoms was 5.2 years. Of the seven patients who underwent surgery for symptoms related to MWD, five had a triple arthrodesis, one had triple arthrodesis combined with naviculo-cuneiform fusion, and one had a pantalar arthrodesis for associated varus ankle osteoarthritis. Solid union was achieved in all cases.
We propose that MWD is much more common than previously reported and did not find conditions of extreme environmental stress or poverty in our patients. We advocate surgical management of the condition by triple arthrodesis and extend it to include a naviculocuneiform fusion whenever indicated according to CT findings.
Müller-Weiss 病（MWD）是一种病因不明的罕见疾病，其特征为跗骨舟状骨外侧受压。它表现为慢性中后足疼痛，主要发生在中年女性。它不代表科勒氏病的持续存在，后者是自限性的，在儿童期完全消退。
10 年间，共有 12 名患者的 19 只受累足就诊于一位足踝外科医生，其中 7 名患者为双侧受累。MWD 的诊断基于影像学表现，显示出舟状骨外侧部分受压。受累足采用 Maceira 分类进行分级。
该队列包括 4 名男性和 8 名女性，平均年龄为 57.9 岁。仅有 1 名患者曾为体力劳动者。症状的平均持续时间为 5.2 年。在因 MWD 相关症状而接受手术的 7 名患者中，5 例行三关节融合术，1 例行三关节融合术联合舟楔融合术，1 例行距下关节融合术治疗伴发的内翻踝关节炎。所有病例均达到了骨性愈合。
我们提出 MWD 比之前报道的更为常见，而且我们在患者中未发现极端环境压力或贫困条件。我们主张通过三关节融合术来治疗该疾病，并根据 CT 结果将其扩展到包括舟楔融合术。
