One of the most troubling foot issues affecting athletes, and the doctors caring for
them, is the navicular stress fracture. A physician treating a patient with this unpredictable
entity should be experiencing a fair amount of anxiety; if not, the physician has
not treated enough of them. The report in this issue of JFAS, by Saxena et al, helps
us define the indications for surgery and the anticipated results. The numbers reported
are likely the highest of any non–meta-analysis review. The results illustrate the
significant delay in diagnosis that can accompany this entity and the effect that
can have on the outcomes. Thus, many of the fractures could be considered “nonunions”
at the time treatment is initiated, given this delay in presentation and diagnosis.
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References
- Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification system.J Foot Ankle Surg. 2000; 39: 96-103
- Clinical and computed tomography evaluation of surgical outcomes in tarsal navicular stress fractures.Am J Sports Med. 2011; 39: 1741-1748
- Navicular stress fractures: a prospective study on athletes.Foot Ankle Int. 2006; 27: 917-921
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
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- Navicular Stress Fracture Outcomes in Athletes: Analysis of 62 InjuriesThe Journal of Foot and Ankle SurgeryVol. 56Issue 5
- PreviewThe optimal treatment modalities for navicular stress fractures in athletes is currently unknown for this season-ending injury. The present study evaluated factors that might be significant and affect healing outcomes, specifically focusing on the return to activity (RTA) time and a decreased desired activity (DDA) after treatment in athletes. Such considerations included previous navicular stress fractures, patient demographic data and type of sport, and initiation time of treatment. The data from 59 patients with 62 fractures were prospectively analyzed from May 2005 through July 2016.
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