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Navicular Fracture

(Tarsal Navicular Fracture)

Definition

A navicular fracture is a fracture of the navicular bone of the foot, a bone on the top of the midfoot. Athletes are particularly susceptible to fractures of the navicular bone. (There is also a navicular bone in the wrist.)
Navicular Bone of the Foot
si55550253 97870 1 Navicular Bone Foot
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Causes

A navicular fracture can be caused by a fall, severe twist, or direct trauma to the navicular bone. It can also be caused by repeated stress to the foot, creating a fracture not due to any acute trauma (a stress fracture ).

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
The following factors may increase your risk of a navicular fracture:
  • Trauma
  • High-impact sports (such as track and field, gymnastics, tennis, basketball)
  • Being an adolescent
  • In women, abnormal or absent menstrual cycles
  • Military recruits
  • Osteoporosis or other bone conditions

Symptoms

Symptoms of a navicular fracture include:
  • Vague, aching pain in the top, middle portion of your foot, which may radiate along your arch
  • Increasing pain with activity
  • Pain on one foot only
  • Altered gait
  • Pain that resolves with rest
  • Swelling of the foot
  • Tenderness to touch on the inside aspect of the foot

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam, which will include a thorough examination of your foot. Other tests may include:
  • X-ray —to take a picture of possible bone fractures
  • Bone scan— to look for possible bone fractures
  • CT scan —to take a picture of possible bone fractures
  • MRI scan —to take a picture of possible bone fractures. This is particularly useful with stress fractures.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Nonsurgical Treatment

Most cases of navicular fracture respond well to being placed in a cast that holds the bones in place. You will need to use crutches to help you walk. Once the bone has healed, your doctor will recommend a rehabilitation program that will allow you to eventually return to your normal activities.

Surgery

In rare cases of severe fracture, you may need surgery to realign the bone. This involves placing a metal plate and/or screws or pins to hold the bone in place. You will need to wear a cast or splint after the surgery. You will also need to use crutches to help you walk.

Prevention

To prevent navicular fractures and other fractures of the foot:
  • Wear well-fitting, supportive shoes appropriate for the type of activity you are doing.
  • Eat a diet rich in calcium and vitamin D.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles and practice balancing exercises to prevent falls.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org

American Orthopaedic Foot & Ankle Society http://www.aofas.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Coris EE, Lombardo JA. Tarsal navicular stress fractures. American Family Physician website. Available at: http://www.aafp.org/afp/20030101/85.pdf . Accessed June 26, 2007.

Stress fractures of the foot and ankle. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00379 . Accessed June 26, 2007.

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