Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, United Kingdom.
Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, United Kingdom.
Foot Ankle Surg. 2014 Mar;20(1):e7-e10. doi: 10.1016/j.fas.2013.10.002. Epub 2013 Nov 13.
Spontaneous total avascular necrosis of the tarsal navicula has been well documented in children (Kohler's disease) but is uncommon in adults where partial necrosis is usually seen after trauma or in Müller-Weiss disease. A case of spontaneous complete navicular osteonecrosis in a 46 year old female is described; she had accompanying Mee's leuchonychial lines in the toenails of the great and second toes only; the lines resolved after 9 months. She has been treated with an excision of the navicula and interpositional iliac crest bone graft talo-cuneiform fusion with resolution of her pain. It is postulated that the combination of the Mee's lines and avascular necrosis of the navicula indicates an occlusion of the dorsalis pedis in a predisposed individual.
跗舟骨自发性完全性缺血性坏死在儿童中已有充分的文献记载（科勒病），但在成年人中并不常见，成年人中通常在创伤后或在穆勒-魏斯病中见到部分坏死。本文描述了一例 46 岁女性的自发性完全性舟骨骨坏死病例；她只有大脚趾和第二脚趾的甲半月出现米氏白线，9 个月后白线消失；她接受了舟骨切除术和髂嵴骨间植入物距舟楔形融合术治疗，疼痛得到缓解。有人推测，米氏白线和舟骨缺血性坏死的组合表明，在易感个体中存在足背动脉阻塞。
