![]() ![]() Physical examination demonstrates tenderness at the proximal dorsal portion of the navicular bone. Pain often worsens with activity and improves with rest and may be present at the dorsum of the foot, or it may radiate along the medial longitudinal arch. Pain is of insidious onset and may have been present for months. Uncommonly, fracture-dislocation of the navicular may occur in athletes and requires reduction and confirmation of stability, otherwise internal fixation is required. Navicular stress fractures take up to 4 months to heal posttreatment. Navicular stress fractures should be considered in any athlete with midfoot pain. Navicular stress fractures are underdiagnosed and can lead to significant disability if the diagnosis is delayed.Īverage time between stress fracture and diagnosis was estimated to be 7 months. Stress fractures are usually sports-related injuries. Navicular body fractures with 1 mm or more of displacement require open reduction and internal fixation. ![]() Navicular body fracturescan be divided into 3 types: Type 1 is a coronal fracture with no dislocation, Type 2 is a dorsolateral to plantomedial fracture with medial forefoot displacement and Type 3 is a comminuted fracture with lateral forefoot displacement and carries the worst prognosis. Incidence of navicular stress fracture is related participation in sports.Ĭommonly not evident on plain radiographs leadsing to a delay in diagnosis.ĭelay in diagnosis may result in prolonged disabling foot pain in individuals.Ĥ types of navicular fractures are (1) cortical avulsion, (2) tuberosity, (3) body, and (4) stress.Īvulsion fractures are the most common types of fracture of the navicular.Īvulsion fracture is often associated with ligamentous injuries and results from twisting forces on the mid foot.Īvulsion fractures are commonly treated conservatively, except for avulsion of the posterior tibial tendon insertion, a tuberosity fracture, which is usually repaired surgically.įractures of the navicular body are commonly associated with other injuries of the midtarsal joint. Military recruits have an incidence of navicular fractures approaching that of athletes, as the training of military recruits. Highest incidence of stress fractures occurs in field and track atheletes in jumping and sprinting events. Incidence may be increasing due to advances in imaging. May account for up to 35% of stress fractures in athletes. Incidence of 14 to 35% of all stress fractures. ![]()
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