<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1137-6627</journal-id>
<journal-title><![CDATA[Anales del Sistema Sanitario de Navarra]]></journal-title>
<abbrev-journal-title><![CDATA[Anales Sis San Navarra]]></abbrev-journal-title>
<issn>1137-6627</issn>
<publisher>
<publisher-name><![CDATA[Gobierno de Navarra. Departamento de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1137-66272023000100006</article-id>
<article-id pub-id-type="doi">10.23938/assn.1030</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Avascular necrosis of the proximal epiphysis of the first metatarsal bone in childhood. Long-term outcome]]></article-title>
<article-title xml:lang="es"><![CDATA[Necrosis avascular de la epífisis proximal del primer metatarsiano en la infancia. Evolución a largo plazo]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Mata]]></surname>
<given-names><![CDATA[Serafín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Servicio Navarro de Salud-Osasunbidea Hospital Universitario de Navarra Trauma and Orthopaedic Department]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<volume>46</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1137-66272023000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1137-66272023000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1137-66272023000100006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Ten-year old boy with an 8-month history of limping for pain in the dorsomedial region of the right midfoot. At examination, there were signs of local swelling and tenderness to palpation, as well as antalgic gait with internal rotation. X-ray results showed widening of the proximal epiphysis of the first metatarsal. One month later, local fragmentation with hypodense and sclerotic areas was observed. MRI showed fragmentation, sclerosis, and collapse in the proximal epiphysis consistent with avascular necrosis of the proximal epiphysis of the first metatarsal bone. Patient was only recommended to avoid any physical activity that could increase the load on the foot, without pharmacological treatment. Symptoms spontaneously subsided over the course of six weeks and local pain disappeared after four months. Four years later, the patient remains asymptomatic, playing sports. A high index of suspicion is needed to avoid superfluous diagnostic tests, as it is a self-resolving lesion.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Paciente varón de 10 años edad con cojera de 8 meses de evolución por dolor en la zona dorsomedial del antepie derecho. Presentaba inflamación local, dolor local y marcha antiálgica con rotación interna. No existían signos de flogosis, erosiones, eritema o fiebre. La radiografía mostraba ensanchamiento de la epifisis proximal del primer metatarsiano. Un mes después se podía observar fragmentación, esclerosis y colapso en radiografía y en resonancia magnética compatible con necrosis avascular de la epífisis proximal del primer metatarsiano. Se prescribió evitar actividades físicas con carga en el pie. Los síntomas remitieron espontáneamente en las siguientes seis semanas y el dolor local lo hizo tras cuatro meses. Cuatro años más tarde permanece asintomático, realizando deporte. Es una causa excepcional de cojera en la infancia. Se necesita un alto índice de sospecha para evitar realizar pruebas complementarias superfluas dado que es una entidad autoresoluble.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Limping]]></kwd>
<kwd lng="en"><![CDATA[Avascular necrosis]]></kwd>
<kwd lng="en"><![CDATA[Proximal first metatarsal]]></kwd>
<kwd lng="es"><![CDATA[Cojera]]></kwd>
<kwd lng="es"><![CDATA[Necrosis avascular]]></kwd>
<kwd lng="es"><![CDATA[Primer metatarsiano proximal]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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