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Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 128-129

An unusual cause of ankle pain

1 Department of Dermatology, Hitit University Faculty of Medicine, Çorum, Turkey
2 Birecik First Family Health Center, Urfa, Turkey
3 Ministry of National Education, Çorum, Turkey

Date of Web Publication18-Jul-2014

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1658-631X.137016

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How to cite this article:
Senel E, Gunturkun H, Senel SD. An unusual cause of ankle pain. Saudi J Med Med Sci 2014;2:128-9

How to cite this URL:
Senel E, Gunturkun H, Senel SD. An unusual cause of ankle pain. Saudi J Med Med Sci [serial online] 2014 [cited 2023 Mar 26];2:128-9. Available from: https://www.sjmms.net/text.asp?2014/2/2/128/137016

A 29-year-old man presented with a 2-week history of severe pain of his left ankle. He reported no difficulty in the activities of daily living and complained of a slight pain in his left foot during playing basketball or on prolonged standing. He had no recent trauma history. Physical examination did not reveal erythema, edema, varicose veins, and tenderness. His foot showed marked swelling and was pronated and slightly internally rotated [Figure 1]. He had pain on plantar flexion, extension and pronation of the left ankle. No pain was reported on internal or external rotation.
Figure 1: Swelling on the left foot

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  Question Top

What is the diagnosis?

  Answer Top

Radiography disclosed unilateral isolated navicular dislocation without fracture [Figure 2]a and b] and minimal deformation of the cuneiform bones. The patient stated that he had a traffic accident at the age of 5. The patient had been hit by a motorcycle on his left foot.
Figure 2: Radiography of the left foot and ankle showing an isolated navicular dislocation. (a) Anteroposterior radiograph of left foot. (b) Oblique radiograph of left foot

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  Discussion Top

Isolated dislocations of the tarsal bones are extremely rare since strong ligament support the plantar and dorsal sides of the navicular bone. [1],[2] Only six cases of isolated navicular dislocations without fracture are reported in the literature. [1],[2],[3],[4],[5],[6] The pathogenesis of this condition is not clear. [1] This traumatic dislocation involves disruption of both the dorsal and plantar ligaments and capsular structures attached to the navicular. [4] The patient was consulted to the Clinic of Orthopedics and Traumatology. Local intra-articular injection of triamcinolone acetonide was administrated to relieve the pain. Arthrodesis was planned if the patient's condition needed as a further process.

Treatment options of the isolated navicular dislocation and their outcomes are controversial. [1] Closed reduction is not a referable treatment option and recent reports recommended primary arthrodesis, Kirschner wires, and external fixation. [6]

  References Top

1.Gosselin RA, Silverstein RM, Gomez RA. Isolated bilateral tarsal navicular fracture-dislocation. Orthopedics 1992;15:201-5.  Back to cited text no. 1
2.Vaishya R, Patrick JH. Isolated dorsal fracture-dislocation of the tarsal navicular. Injury 1991;22:47-8.  Back to cited text no. 2
3.Dixon JH. Isolated dislocation of the tarsal navicular. Injury 1979;10:251.  Back to cited text no. 3
4.Freund KG. Isolated dislocation of the tarsal navicular. Injury 1989;20:117-8.  Back to cited text no. 4
5.Pathria MN, Rosenstein A, Bjorkengren AG, Gershuni D, Resnick D. Isolated dislocation of the tarsal navicular: A case report. Foot Ankle 1988;9:146-9.  Back to cited text no. 5
6.Yoshino N, Noguchi M, Yamamura S, Takai S, Hirasawa Y. Bilateral isolated tarsal navicular fracture dislocation: A case report. J Orthop Trauma 2001;15:77-80.  Back to cited text no. 6


  [Figure 1], [Figure 2]


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