Houston Methodist. Leading Medicine

Foot FAQ

Question:

Our daughter is a top-notch soccer player. Last week at practice, she got kicked in the shin and again in the ankle. When the shin finally stopped hurting, we realized the ankle was broken. The surgeon called it a nondisplaced, complete stress fracture. We are very new to all this -- we get that it's broken but can you please explain what it all means?

Answer:

The navicular bone of the foot is one of the small bones on the mid-foot. The bone is located at the instep, the arch at the middle of the foot. One of the larger tendons of the foot, called the posterior tibial tendon, attaches to the navicular before continuing under the foot and into the forefoot. This tendon is a tough band of tissue that helps hold up the arch of the foot. Stress fractures are breaks in the bone that occur with repetitive motions, strains, or stresses. Navicular stress fractures are fairly uncommon. The person at greatest risk for this type of fracture is a high-level athlete engaged in activities that involve repeated push-off of the foot. Track and field runners head the list for this type of injury. Any fracture can be further categorized as displaced (ends of the bone separate and possibly shift) or nondisplaced (no separation or shift after fracture). Studies show that complete, displaced fractures are more likely to remain as nonunion fractures. Some surgeons advise surgery to prevent nondisplaced fractures from separating and becoming displaced fractures (less likely to heal). The fracture is held together with screws, wires, bone graft material, or some combination of those fixation devices. The earlier navicular stress fractures are treated (with or without surgery), the better the results. Jeremy J. McCormick, MD, et al. Clinical and Computed Tomography Evaluation of Surgical Outcomes in Tarsal Navicular Stress Fractures. In The American Journal of Sports Medicine. August 2011. Vol. 39. No. 8. Pp. 1741-1748.

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