Description of patient (type of occupation, indication of age, intensity of sport):
Female 72 yrs foot twist then pain and swelling at lateral of midfoot
History and previous treatment:
Conservarive treatment of medication, rest and life style modifixation but not improve
Current complaints:
Still pain
Physical examination:
Mild swelling and pain lateral of midfoot
Radiology:
X-ray:
[Picture 1]: Displaced of os peroneum. Fracture of osteophyte
Additional investigation (CT/MRI): -
Images:
Case summary:
72 yrs female midfoot pain after injury and not improve by conservative treatment
Question(s) to this case:
What is proper management?
Expert:
Assuming the pain comes from the cuboid area : we need to be informed about the peroneal tendons.
Is the peroneus brevis insertion still intact to the base of the V metatarsal? Or is there an avulsion of the base!
If there is no avulsion of the V base then possibly the solution might be cutting the peroneus longus tendon.
PS is the calcaneocuboid joint symptomatic?
Member:
Peroneous brevis is still intact
Calcaneocuboid is asymptomatic
Now I sent MRI for evaluate Peroneal tendon
I will inform you for more information for other suggestion in management
Thank you for your kindness
Expert:
Ìf peronus brevis is intact then the pain probably comes from the longus(with its sesamoidbones inside) rubbing against the damaged cuboid. At this age then probably best to explore and debride and cut the longus and tenodese the proximal stump to the brevis