![]() ![]() Hence a decision was made to excise the dislocated bone which showed good result. Also arthrodesis between tarsal bones has been associated with poor results. It was decided not to attempt open reduction in this case because of high possibility of avascular necrosis if the dislocated bone was reduced. The bone was deformed in our case and ligamentous healing with fibrosis was noticed on surgical exploration. Deformed bone, mechanical impingement of the bone and bursa formation around the bone are the factors causing pain. The dislocated bone gets deformed due to repeated weight bearing. The plantar dislocation of bone detaches the dorsal vessels supplying the bone and leads to avascular necrosis. The resultant force may concentrate at intermediate cuneiform and ligament injury may be limited to the ligaments around the intermediate cuneiform. The mechanism for the planter dislocation is a direct vertical force to the dorsum of midfoot that compresses and flattens the transverse and longitudinal arch. ĭislocation of middle cuneiform has been reported in middle age group males. It receives its vascularity from dorsal surface mainly and also from medial and lateral surfaces. Besides these the interosseous ligaments between the adjacent bones and the dorsal transverse ligaments provide added stability. Very strong deep planar ligaments, superadded with the tendinous slips of tibialis posterior muscle and the shape of the bone with a base dorsally are the factors which provide plantar stability to the bone. The middle cuneiform is a wedge shaped bone. ![]()
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