Navicular stress fractures: outcomes of surgical and conservative management
- 12 April 2006
- journal article
- Published by BMJ in British Journal of Sports Medicine
- Vol. 40 (8), 692-695
- https://doi.org/10.1136/bjsm.2005.022079
Abstract
To compare the long term outcomes of the two treatment options for navicular stress fractures: non-weightbearing cast immobilisation and surgical fixation. Retrospective case study. Subjects aged 18 years and older who had been treated for a navicular stress fracture more than two years previously. Questionnaire based analogue pain score and function score; tenderness on palpation; abnormality detected on computed tomography (CT). In all, 32 fractures in 26 subjects were investigated. No significant differences were found between surgical and conservative management for current pain (p = 0.984), current function (p = 0.170), or abnormality on CT (p = 0.173). However, surgically treated patients more often remained tender over the "N spot" (p = 0.005), even after returning to competition for two years or more. Surgical fixation of navicular stress fractures appears to be as effective as conservative management over the longer term. However, there remains a small but measurable degree of pain and loss of function over this period. The value of using "N spot" tenderness as the sole clinical predictor of treatment success requires further investigation, as some patients remained tender despite successful completion of treatment and return to competition.Keywords
This publication has 10 references indexed in Scilit:
- Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification systemThe Journal of Foot and Ankle Surgery, 2000
- Stress fractures: a review of 180 cases.1996
- Stress FracturesClinical Journal of Sport Medicine, 1996
- The Incidence and Distribution of Stress Fractures in Competitive Track and Field AthletesThe American Journal of Sports Medicine, 1996
- Clinical Rating Systems for the Ankle-Hindfoot, Midfoot, Hallux, and Lesser ToesFoot & Ankle International, 1994
- Tarsal Navicular Stress Fracture in AthletesSports Medicine, 1994
- Stress fractures of the tarsal navicular bone: CT findings in 55 cases.American Journal of Roentgenology, 1993
- Outcome of conservative and surgical management of navicular stress fracture in athletesThe American Journal of Sports Medicine, 1992
- Stress fractures of the tarsal navicular. A retrospective review of twenty-one cases.The Journal of Bone & Joint Surgery, 1982
- Fatigue Fracture of the Tarsal NavicularThe Journal of Bone & Joint Surgery, 1970