Best Practice Case Studies-Navicular Stress Fractures

Pdf Summary

Navicular stress fractures are injuries that primarily affect athletes due to high-impact activities, which place significant stress on the tarsal navicular bone in the foot. Initially considered rare, these fractures now represent up to 35% of stress fractures due to increased awareness. The central portion of the navicular bone is most susceptible to fractures because of concentrated forces during movements such as heel strikes and decreased vascularity in this area.<br /><br />Anatomically, the navicular bone, located in the medial foot, is compressed between the talus and the cuneiforms during activities, making it prone to stress fractures. Despite various suspected contributing factors like foot structure abnormalities, no statistical significance has been solidly determined.<br /><br />Diagnosing navicular stress fractures can be challenging due to vague symptoms, typically presenting as insidious onset midfoot pain exacerbated by physical activity. Often, the pain is localized along the dorsolateral aspect of the foot as the condition progresses. Conventional x-rays, CT, MRI, and bone scans are utilized for diagnosis. Although initial x-rays might not show fractures, advanced imaging techniques can confirm their presence, revealing details like fracture location and severity.<br /><br />Treatment typically involves aggressive management to prevent prolonged disability. Non-operative treatment includes casting and non-weight-bearing protocols, though persistent cases may require surgical intervention with techniques like percutaneous screw fixation. This approach aims to enable athletes to return to their activities within an average of 3 to 8 months, depending on the fracture type and severity. Surgical intervention might occur sooner in cases of complete fractures or when immediate recovery is needed. <br /><br />Ultimately, a high index of suspicion and prompt, appropriate treatment are critical to managing navicular stress fractures to allow athletes a timely return to peak performance without impacting long-term outcomes.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 12

Topic Foot and Ankle

Keywords

navicular stress fractures

athletes

high-impact activities

tarsal navicular bone

foot injuries

diagnosis

treatment

imaging techniques

surgical intervention

recovery time

2nd Edition

2nd Edition, CASE 12

Foot and Ankle