Avascular necrosis of the navicular (Müller-Weiss). A systematic review.

Abstract

Müller-Weiss is a disease characterized by deformation, fragmentation and necrosis of the navicular, which presents with midfoot varus and long-standing pain, mostly in females. It is related to delayed ossification due to physical or nutritional stress, associated with abnormal force distribution. There are still few studies on this condition and there is no consensus in the literature on its classification and treatment. At first, conservative treatment does not show positive results, only acute symptomatic improvement. Isolated talonavicular arthrodesis is the method most commonly adopted by specialists, showing good results and scores in the early stages, while triple and double arthrodesis is the choice in advanced stages. Knowledge of the radiology and findings is important for planning and individualizing the choice of treatment in each case. At the moment, there are several different techniques for approaching Müller-Weiss disease, however, studies evaluating long-term approaches as well as their complications need to be carried out. We present a systematic review on this disease.