Fatigue Fracture of the Tarsal Navicular

Towne, Louis C.; Blazina, Martin E.; Cozen, Lewis

doi:10.2106/00004623-197052020-00023

Cited by 88 publications

(26 citation statements)

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“…The stress fracture of the tarsal navicular was first described in humans in a 1970 case study by Towne et al 31 Early studies showed that it was a rare injury, accounting for only 0.7% to 2.4% of all stress fractures. As awareness of the injury has increased, so have the reported number of cases, with tarsal navicular stress fractures currently representing up to 14% of stress fractures in some series.…”

mentioning

confidence: 99%

Management of Tarsal Navicular Stress Fractures

et al. 2010

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Non-weightbearing conservative management should be considered the standard of care for tarsal navicular stress fractures. The authors could find no advantage for surgical treatment compared with NWB immobilization. However, there is a statistical trend favoring NWB over surgery. Rest or immobilization with weightbearing was inferior to both other treatments analyzed. The authors concluded that conservative NWB management is the standard of care for initial treatment of both partial and complete stress fractures of the tarsal navicular.

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confidence: 99%

Management of Tarsal Navicular Stress Fractures

et al. 2010

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“…',', &dquo;, 11,11,20 In this study, the average time from the onset of pain to diagnosis was 4.0 months (range, 3 to 60 months). This delay occurred for a number of reasons.…”

Section: Delayed Diagnosismentioning

confidence: 67%

Outcome of conservative and surgical management of navicular stress fracture in athletes

et al. 1992

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Eighty-two athletes with 86 clinical navicular stress fractures, all imaged with computerized tomography, were followed for an average of 33 months (range, 6 to 108) after diagnosis. Initial treatment consisted of at least 6 weeks of nonweightbearing cast immobilization for 22 fractures, at least 6 weeks of limitation of activity with continued weightbearing for 34 fractures, and a period of less than 6 weeks of conservative treatment for another 19 fractures. Five patients attempted to continue playing sports. Six patients had immediate surgery. Nineteen of 22 patients (86%) who had initial non-weightbearing cast immobilization treatment returned to sports, compared with only 9 of 34 patients (26%) who initially continued weightbearing with limited activity (P < 0.001). After failure of the latter treatment, successful outcomes were seen for 6 of 7 patients (86%) treated with nonweightbearing cast immobilization, while 11 of 15 patients (73%) who had one surgical procedure were able to return to sports. These results indicate that nonweightbearing cast immobilization is the treatment of choice for navicular stress fractures. Also, this treatment compares favorably with surgical treatment for patients who present after failed weightbearing treatments. Computerized tomographic appearances of healing fractures do not necessarily mirror clinical union, and postimmobilization management should be monitored clinically.

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“…1 Since then, the reported incidence has increased from 0.7%-2.4% in the 1980s 2,3 to 14%-35% of all foot and ankle stress fractures. [4][5][6] This may be owing to increased recognition of the signs, symptoms, and radiographic modalities needed to properly diagnose these stress fractures.…”

Section: Navicular Stress Fracturesmentioning

confidence: 99%