• 1. 

    Tachdjian MO(ed): Pediatric Orthopedics, WB Saunders, Philadelphia, 1972.

  • 2. 

    Karp MG: Kohler's disease of the tarsal scaphoid. J Bone Joint Surg Am 19 : 84, 1937.

  • 3. 

    Waugh W: The ossification and vascularization of the tarsal navicular and their relation to Kohler's disease. J Bone Joint Surg Br 40 : 765, 1958.

    • Search Google Scholar
    • Export Citation
  • 4. 

    Viladot A, Rochera R & Viladot A: Necrosis of the navicular bone. Bull Hosp Jt Dis Orthop Inst 47 : 285, 1987.

  • 5. 

    Samarasinghe YP, Brunton, SL & Feher MD: Avascular necrosis not Charcot's. Diabet Med 18 : 846, 2001.

  • 6. 

    Catonne Y, Ribeyre D & Pascal-Mousselard H et al.: Aseptic necrosis of the navicular bone: 25 cases. J Bone Joint Surg Br 86 (suppl 1) : 56, 2004.

  • 7. 

    DiGiovanni CW: Fractures of the navicular. Foot Ankle Clin 9 : 25, 2004.

  • 8. 

    Eichenholtz SN & Levine DB: Fractures of the tarsal navicular bone. Clin Orthop Relat Res 34 : 142, 1964.

  • 9. 

    Davis GA, Lubowitz J & Thordarson DB: Midtarsal fracture-subluxation: case report and review of the literature. Clin Orthop Relat Res 292 : 264, 1993.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. 

    Main BJ & Jowett RL: Injuries to the midtarsal joint. J Bone Joint Surg Br 57 : 89, 1975.

  • 11. 

    Sangeorzan BJ, Benirschke SK & Mosca V et al.: Displaced intra-articular fractures of the tarsal navicular. J Bone Joint Surg Am 71 : 1504, 1989.

  • 12. 

    Boc SF & Feldman G: Bilateral spontaneous avascular necrosis of the navicular: case presentation with comparative imaging. JAPMA 88 : 41, 1988.

    • Search Google Scholar
    • Export Citation
  • 13. 

    Resnick D, Niwayama G & Sweet DE et al.: “Osteonecrosis,” in Bone and Joint Imaging, edited by Resnick, D p 959, WB Saunders, Philadelphia, 1989.

  • 14. 

    Ertel AN & O'Connell FD: Talonavicular coalition following avascular necrosis of the tarsal navicular. J Pediatr Orthop 4 : 482, 1984.

  • 15. 

    Lawerence SJ: Midfoot trauma, bony and ligamentous: evaluation and treatment. Curr Opin Orthop 13 : 99, 2002.

  • 16. 

    Adelaar RS: Complications of forefoot and midfoot fractures. Clin Orthop Relat Res 391 : 26, 2001.

  • 17. 

    Ahmed J & Raikin SM: Osteonecrosis of the second metatarsal head, navicular and talus. Curr Opin Orthop 17 : 103, 2006.

  • 18. 

    Lee EW & Donatto KC: Fractures of the midfoot and forefoot. Curr Opin Orthop 10 : 224, 1999.

  • 19. 

    Sarrafian SK. Anatomy of the Foot and Ankle, JB Lippincott, Philadelphia, 1983.

  • 20. 

    Haller J, Santoris DJ & Resnick D et al.: Spontaneous osteonecrosis of the tarsal navicular in adults: imaging findings. AJR Am J Roentgenol 151 : 355, 1988.

  • 21. 

    Schildhauer TA, Nork SE & Sangeorzan BJ: Temporary bridge plating of the medial column in severe midfoot injuries. J Orthop Trauma 17 : 513, 2003.

  • 22. 

    Chandran P, Puttaswamaiah R & Dhillon MS et al.: Management of complex open fracture injuries of the midfoot with external fixation. J Foot Ankle Surg 45 : 308, 2006.

  • 23. 

    Haidukewych GJ: Temporary external fixation for the management of complex intra- and periarticular fractures of the lower extremity. J Orthop Trauma 16 : 678, 2002.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24. 

    Melamed EA & Seligson D: Mini external fixator for tarsal navicular fractures: a biomechanical study. J Bone Joint Surg Br 82 (suppl 3) : 232, 2000.

    • Search Google Scholar
    • Export Citation

External Fixation Diastasis Management of Kohler's Disease in a 14-Year-Old Boy: A Case Report

View More View Less
Restricted access

A case presentation of an adolescent with tarsal navicular avascular necrosis is presented. External fixation with tarsal navicular diastasis is a simple, straightforward management option to allow osseous regrowth and bone healing. In this case, the external fixator was well tolerated and the patient demonstrated a quick return to function without pain or discomfort. The external fixation technique with tarsal navicular diastasis is an uncommon but effective means of reversing the tarsal navicular avascular process and avoiding an open technique such as arthrodesis.

The Osteomyelitis Center of Central Florida, 5421 S Florida Ave, Lakeland, FL 33813. (E-mail: drkarrcoe@gmail.com)