Treatment of Choice for Navicular Foot FractureYears ago studies showed the best treatment for a tarsal navicular stress fracture (NSF) of the foot in athletes was at least six weeks in a cast. The person wasn't allowed to put any weight on the foot. Today doctors avoid immobilizing athletes whenever possible. This study looks at the long-term results of that decision for NSF.
Nineteen (19) patients with navicular stress fractures were followed for at least one year. The navicular bone is in the mid-foot area. It is on the same side as the big toe and just in front of the tarsal bone at the true ankle joint.
With a stress fracture no fracture line appears on X-rays or CT scans. A positive bone scan for increased bone activity helps make the diagnosis. The patient usually reports midfoot pain with weight-bearing activities.
All patients were seen at a university sports medicine center. Less than half were treated with nonweight-bearing rest. Only two patients got the recommended care of cast immobilization for six weeks. Six patients were able to get back to their previous level of sports activity.
The authors report poor results for athletes with NSF who weren't casted. They suggest that even though casting and nonweightbearing aren't very popular, this treatment is still the best choice for patients with NSF. More studies are needed in the area of NSF and tissue engineering for bone healing. More advanced treatment might help speed up the recovery time.
Scott G. Burne, MBBS, FACSP, et al. Tarsal Navicular Stress Injury. Long-Term Outcome and Clinicoradiological Correlation Using Both Computed Tomography and Magnetic Resonance Imaging. In The American Journal of Sports Medicine. December 2005. Vol. 33. No. 12. Pp. 1875-1881.
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