Houston Methodist. Leading Medicine

Foot FAQ

Question:

After weeks of foot pain, a bone scan finally showed I have a tarsal navicular fracture. Since I've been walking around on the dang thing all this time, I only made it worse. Now I'm in a leg cast on crutches. Will it heal? How long does it take?

Answer:

The navicular bone is the one you can feel sticking up the most on top of the foot. For people with a high arch, that bone is often prominent enough to rub against the shoe causing irritation. The tarsal bone is between the navicular and the calcaneus (the heel bone). Fractures in this area can be difficult to see with plain X-rays. Many fractures in this area are located in the central one-third of the bone. The initial fracture might be partial but can become complete if the patient continues to put weight on it. That's when imaging studies pick up on the injury. Based on a recently published systematic review, we know a little bit more about the care and treatment of these injuries. In a systematic review, orthopedic experts take a look at all the published reports on single topic like tarsal navicular stress fractures. Because this injury is uncommon, there aren't large studies with 100s of people to learn from. So in order to find out how these injuries respond to treatment, it becomes necessary to look at the combined data from many smaller studies. A systematic review makes it possible to look at type of navicular stress fractures, how they are treated, and the result of that treatment. There are two main types of navicular stress fractures: complete and incomplete. Treatment is also broken down into two main categories: conservative (nonoperative) and surgical. They basically found that the approach you are now following works best: nonweight-bearing for six to eight weeks. Then a couple of weeks in a walking cast or special boot as you start to gradually put more and more weight on the foot. The protocol calls for another two weeks at least. You may find it necessary to continue using the walking cast/boot for up to six full weeks. It's based on your pain levels (you must be pain free to walk without this support) and X-ray results showing the stage of healing. Most athletes with this type of fracture are back to full participation in their sport within six months' time. The average nonathlete might find it takes a little longer than that. For some people, less activity and lower demands on the foot can mean faster recovery. Joseph S. Torg, MD, et al. Management of Tarsal Navicular Stress Fractures. In The American Journal of Sports Medicine. May 2010. Vol. 38. No. 5. Pp. 1048-1053.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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