(Tarsal Navicular Fracture)
DefinitionA navicular fracture is a fracture of the navicular bone of the foot, a bone on the top of the midfoot. Athletes are particularly susceptible to fractures of the navicular bone. (There is also a navicular bone in the wrist.)
|Navicular Bone of the Foot|
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CausesA navicular fracture can be caused by a fall, severe twist, or direct trauma to the navicular bone. It can also be caused by repeated stress to the foot, creating a stress fracture unrelated to acute trauma.
Risk FactorsFactors that may increase your chance of a navicular fracture include:
- High-impact sports, such as track and field, gymnastics, tennis, or basketball
- Being an adolescent
- In women, abnormal or absent menstrual cycles
- Military recruits
- Osteoporosis or other bone conditions
SymptomsNavicular fracture may cause:
- Vague, aching pain in the top, middle portion of your foot, which may radiate along your arch
- Increasing pain with activity
- Pain on one foot only
- Altered gait
- Pain that resolves with rest
- Swelling of the foot
- Tenderness to touch on the inside aspect of the foot
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done, which will include a thorough examination of your foot.Imaging tests evaluate the foot and surrounding structures. These may include:
TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include:
Nonsurgical TreatmentMost cases of navicular fracture respond well to being placed in a cast that holds the bones in place. You will need to use crutches to help you walk. Once the bone has healed, your doctor will recommend a rehabilitation program that will allow you to eventually return to your normal activities.
SurgeryIn rare cases of severe fracture, you may need surgery to realign the bone. This involves placing a metal plate and/or screws or pins to hold the bone in place. You will need to wear a cast or splint after the surgery. You will also need to use crutches to help you walk.
PreventionTo help reduce your chance of a navicular fracture (or other foot fractures):
- Wear properly fitting, supportive shoes appropriate for the type of activity you are doing
- Do weight-bearing exercises to build strong bones
- Build strong muscles and practice balancing exercises to prevent falls
Foot Care MD—American Orthopaedic Foot & Ankle Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Coris EE, Lombardo JA. Tarsal navicular stress fractures. Am Fam Physician. 2003;67(1):85-91.
Stress fractures of the foot and ankle. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00379.Updated July 2009. Accessed August 21, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 08/2014
- Update Date: 09/30/2013
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