Congenital Absence of the Navicular Bone: A Rare Cause of Adult-Acquired Flatfoot and Posterior Tibial Tendon Dysfunction.

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Abstract

Conflict of interest statement: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 15. Medicine (Baltimore). 2016 Dec;95(51):e5346. doi: 10.1097/MD.0000000000005346. The effect of polydeoxyribonucleotide prolotherapy on posterior tibial tendon dysfunction after ankle syndesmotic surgery: A case report. Lim TH(1), Cho HR, Kang KN, Rhyu CJ, Chon SW, Lim YS, Yoo JI, Kim JW, Kim YU. Author information: (1)Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul Department of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Seonam University, Goyang Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul Department of Anesthesiology and Pain Medicine, Institute for Integrative medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary's Hospital, Incheon, Republic of Korea. RATIONALE: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors. PATIENT CONCERNS: A 67-year-old woman who presented at our pain clinic with pain on the inside of ankle. She had a syndesmotic screw fixation 3 years prior. Her ankle pain had persisted after the removal of screws and edema for about 1 month resulting from long-term NSAIDs administration. DIAGNOSES: The origin of the pain was possibly tibialis posterior muscle and posterior tibial tendon and she was diagnosed as PTTD after syndesmosis surgery. INTERVENTIONS: Sono guided prolotherapy with PDRN was carried out. OUTCOMES: Patient showed improvement in the arch of the foot, experienced pain relief, and was able to wear regular shoes without any orthopedic device. LESSONS: This case report highlights that PDRN prolotherapy is a safe and efficient therapeutic option for the treatment of PTTD. DOI: 10.1097/MD.0000000000005346 PMCID: PMC5181806