A rare case of bilateral cuboid-navicular coalitions.

Abstract

Cuboid-navicular coalitions are an exceptionally rare form of tarsal coalitions, representing less than 1% of all tarsal coalitions. Although tarsal coalitions classically become symptomatic during adolescence, cuboid-navicular coalitions may remain clinically silent until adulthood and can present with nonspecific chronic midfoot or hindfoot pain. We present a rare case of bilateral cuboid-navicular coalitions in a 42-year-old man with progressive bilateral midfoot pain, associated degenerative hindfoot and midfoot changes, and bilateral peroneal tendon pathology. Initial management consisted of orthotics, bracing, and nonsteroidal anti-inflammatory drugs, but symptoms progressed over 8 years. Cross-sectional imaging demonstrated bilateral cuboid-navicular coalitions, progressive degenerative changes, and high-grade right peroneus longus tear. The patient underwent excision of the right cuboid-navicular coalition, excision of the right lateral calcaneal tubercle with inferior peroneal retinacular release, and debridement and repair of the right peroneus longus and brevis tendons. This case highlights the importance of considering rare tarsal coalitions in adults with chronic nonspecific midfoot pain and emphasizes the value of MRI and CT for diagnosis, characterization of associated pathology, and operative planning.