Tarsal Navicular Stress Injury

Burne, Scott G.; Mahoney, Chris M.; Forster, Bruce B.; Koehle, Michael S.; Taunton, Jack; Khan, Karim M.

doi:10.1177/0363546505278253

Cited by 72 publications

(28 citation statements)

References 21 publications

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“…However even these authors concede that a large proportion of these fractures do not show radiological evidence of union at followup. [5] Surely, this would put them at increased risk of re-injury if these athletes were to return to the same level of sporting competition for any length of time.…”

Section: Discussionmentioning

confidence: 99%

“…[5] The compliance level with this prolonged immobilization especially among athletes is poor. We propose an alternative whereby, following minimally invasive surgery, the patient is able to bear weight immediately and does not require cast immobilization.…”

Section: Discussionmentioning

confidence: 99%

“…[123] Microangiographic studies of cadaveric feet revealed that this central third of the naviculum bone is an area of relative avascularity. [45] These two factors predispose the central third of the proximal articular surface of the tarsal naviculum bone to be the most common site for stress fractures [Figure 1]. …”

Section: Introductionmentioning

confidence: 99%

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Navicular stress fractures treated with minimally invasive fixation

Jacob

Paterson

2013

IJOO

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Background:Stress fractures of the naviculum bone are uncommon injuries occurring predominantly in athletes. These fractures are usually treated nonoperatively with a nonweight bearing cast for a minimum of 6 weeks followed by rehabilitation. Further, there is a paucity of literature on the long term clinical followup of these patients. These fractures do not heal predictably with conservative management, which does not inspire great compliance and their clinical outcome is variable. We report on the outcome of these fractures following early operative intervention by minimally invasive fixation and early weight bearing and rehabilitation. We propose that this is reliable and a successful treatment regimen and its role as the definitive management of this clinical problem should be explored.Materials and Methods:Nine athletes with ten stress fractures of the navicular treated at our institution between April 1991 and October 2000. The mean age of the patients was 22.8 years (range 18-50 years). All patients were treated by minimally invasive screw fixation and early weight bearing mobilization without a cast. The average followup was 7 years (range 2-11 years).Results:Seven of the nine patients returned to their pre-fracture level of sporting activity at an average of 5 months (range 3-9 months). One patient returned to full sporting activity following a delay of 2 years due to an associated tibial stress fracture and one patient had an unsatisfactory result. Long term review at an average of 7 years showed that six of these eight patients who returned to sports remained symptom free with two patients experiencing minimal intermittent discomfort after prolonged activity.Conclusions:We recommend percutaneous screw fixation as a reliable, low morbidity procedure allowing early return to full sporting activity without long term complications or recurrences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Navicular stress fractures treated with minimally invasive fixation

Jacob

Paterson

2013

IJOO

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“…MRI possesses the significant advantages of diagnosing a navicular stress reaction prior to the development of a stress fracture, and excluding a wide range of bony and soft tissue differential diagnoses. The sensitivity and specificity of MRI for the diagnosis of navicular stress fracture are not well established, although anecdotally they are considered similar to CT. Burne et al . conducted the only published comparison of CT and MRI for patients with navicular stress fracture, at a median of 3.7 years following initial presentation.…”

Section: Imagingmentioning

confidence: 99%

“…Bone scan is a poor choice for monitoring fracture healing becuase of the persistence of abnormal appearances in healed fractures . There are conflicting reports as to whether CT and MRI monitoring of fracture healing is effective …”

Section: Imagingmentioning

confidence: 99%

Imaging of tarsal navicular stress injury with a focus on MRI: A pictorial essay

Harris

2016

J Med Imag Rad Onc

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SummaryPredominantly diagnosed in athletes, stress fracture of the tarsal navicular is becoming increasingly recognised by clinicians as a cause of midfoot pain. Delayed diagnosis can increase the significant morbidity associated with this condition. Consequently the role of MRI is increasing, given the potential to identify a stress reaction in the navicular prior to the development of a discrete stress fracture. It is necessary for radiologists to be familiar with the typical and atypical appearances of this important condition.

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