We present the case of a 32-year-old female marathon runner with a symptomatic bipartite medial cuneiform. The bipartite articulation was best visualized on a 30° external oblique radiograph of the foot. Surgical exploration revealed a noncartilaginous articulation between the two osseous segments. The smaller medial segment was excised. Postoperatively the patient's symptoms resolved, and at one-year follow-up she remains asymptomatic and has returned to competitive running. This case demonstrates that surgical excision is indicated for a symptomatic bipartite medial cuneiform that fails to respond to nonoperative measures.
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