Displaced intra-articular fractures of the tarsal navicular.

Fracture dislocation of the tarsal navicular bone: a case report and proposed mechanism of injury

“…In forced plantarflexion, the dorsal talonavicular ligament and the dorsal talocalcaneal ligament and capsule are subjected to tensile forces which may cause them to rupture or tear. With the hindfoot in eversion the transverse tarsal joint is mobile allowing motion of the forefoot on the hindfoot; however, with the hindfoot in inversion the strong plantar calcaneonavicular ligament combined with the bony anatomy locks the transverse tarsal joint [5, 6]. In injuries with the foot in plantarflexion and hindfoot inversion, a compressive force on the midfoot or forefoot would cause vertical fractures through the body of the navicular and cuneiform bones [1].…”

“…Closed reduction alone has been shown to lead to recurrent dislocation and osteoarthrosis [1, 2, 10, 11]. Open reduction and internal fixation has been associated with a vascular necrosis secondary to the tenuous blood supply [6, 12]. In this case we elected to treat with a closed manipulation as a satisfactory alignment was achievable without risk or compromise to the navicular blood supply.…”

What the Orthopaedic Foot and Ankle Surgeon Wants to Know from MR Imaging

“…Beside of degenerative osteoarthritis of the talonavicular joint, the most common complication following fracture is avascular necrosis. 3 Avascular necrosis can also occur without trauma. In most instances, the lateral third of the navicular bone is affected.…”

Diagnostik und Therapie von Chopart-Luxationsfrakturen

“…Bei korrekter Indikationsstellung können tarsale Distorsionen nach initialer Ruhigstellung funktionell für 5 Wochen im Tape-Verband behandelt werden [22]. Instabile Chopart-Subluxationen mit nur marginaler knöcherner Beteiligung haben bei Ruhigstellung im Unterschenkel-Cast für 6 Wochen eine gute Prognose [26,31]. Dislozierte Avulsionen der Tibialis-posterior-Sehne hingegen sollten operativ refixiert werden, um der Ausbildung eines posttraumatischen Pes planus entgegenzuwirken [5].…”

“…Infektverläufe wurden vor allem bei verzögerter Versorgung gesehen, was die Wichtigkeit der notfallmäßigen Reposition schwerer Dislokationen unterstreicht [16]. Aufgrund der prekären Blutversorgung des Os naviculare ist besonders mit zunehmendem Patientenalter mit der Ausbildung einer avaskulären Nekrose zu rechnen [26,32].…”