eMedicine Specialties > Sports Medicine > Foot and Ankle

Navicular Fracture: Treatment & Medication

Author: Michael J Ameres, MD, Consulting Staff, Department of Emergency Medicine, Southampton Hospital
Coauthor(s): Greg Montalbano, MD, Assistant Clinical Professor, Department of Orthopaedics, New York University Medical School; Rafat Farouqui, MBBS, Consulting Staff, Department of Orthopedic Surgery, Brooklyn Hospital Center; Benson Yeh, MD, Assistant Program Director, Department of Emergency Medicine, Brooklyn Hospital Center; Clinical Instructor, Department of Medicine, Division of Emergency Medicine, Cornell University
Contributor Information and Disclosures

Updated: Feb 11, 2008

Treatment

Acute Phase

Rehabilitation Program

Physical Therapy

Most patients are placed in a non–weight-bearing cast for 6 weeks. The importance of following a strict non–weight-bearing protocol must be emphasized to the patient. After 3 weeks, the state of the cast and the patient's adherence to the non–weight-bearing protocol must be assessed.

An exception to non–weight-bearing treatment is in patients who have pain only after significant exertion (eg, pain after running 2 miles). In these individuals, avoidance of running for 6-8 weeks may be sufficient to heal the fracture. The patient can then gradually return to his or her normal routine. If pain returns, then a non–weight-bearing cast may be indicated.

Surgical Intervention

Most physicians do not recommend immediate open surgical procedures when treating uncomplicated navicular stress fractures. In a comparison study by Potter et al, surgery had similar long-term return-to-activity rates relative to conservative therapy.45 In another study, bone healing took up to 4 months, for both operative and nonoperative treatment.9

Fractures that are complicated by dislocation are assessed for stability following reduction. If the navicular is stable, then treatment may continue as outlined for uncomplicated navicular fractures. If the navicular is unstable, then internal fixation is required.

A complete fracture with wide separation may benefit from early surgical intervention. In addition, if the patient is not expected to tolerate the rehabilitation program, surgical correction may be considered.

Other Treatment

Although no trials support the use of bone growth stimulators for navicular stress fractures, they may be a helpful adjunct.10 In particular, bone growth stimulators that use pulsed electromagnetic fields (PEMFs) have been shown to have similar success rates when compared with open repair in tibial fracture nonunions.46,47,48,49 Whether these results are applicable to acute fractures and fractures of the navicular remains to be determined.

Recovery Phase

Rehabilitation Program

Physical Therapy

After the affected foot has been placed in a non–weight-bearing cast for 6 weeks, the cast is removed and tenderness at the N spot is assessed. If tenderness persists, then an additional 2 weeks of non–weight-bearing cast immobilization is recommended. However, if tenderness is not present at the N spot, then weight-bearing activity may begin. This activity is limited to a gradual return to normal activity under the care of a sports physician or physical therapist. The therapy may include muscle strengthening, range-of-motion exercises, and soft-tissue massage.

A stepwise regimen for the course of activity is as follows:

  1. The patient participates in his or her normal activities of daily life (ADLs), which may include swimming, for 2 weeks (Weeks 1 and 2).
  2. If the athlete remains free of pain after 2 weeks, a gradual return to jogging may be prescribed.
  3. After 2 weeks of a gradually progressive jogging regimen (Weeks 3 and 4), the patient is again assessed for pain.
  4. If the patient remains free from pain after 2 weeks after gradually progressing in the jogging regimen, then the athlete may gradually return to full activity over the final 2 weeks of the rehabilitation program (Weeks 5 and 6).

Medical Issues/Complications

Delayed union and nonunion produce persistent pain at the navicular. Plain radiographs and/or a CT scan may show the persistent fracture. In such cases, referral to a surgeon is required for open reduction and fixation. In addition, fracture of the tarsal navicular may be complicated by avascular necrosis.

Surgical Intervention

A comparison study of surgery relative to conservative treatment by Potter showed no difference in an athlete's long-term return to activity.45 However, tenderness was more common in the surgical group. Some athletes who successfully returned to activity for 2 years or more had persistent tenderness at the N-spot.

In a study by Saxena and Fullem that compared nonoperative treatment with operative treatment, navicular stress fractures took up to 4 months to heal, regardless of the therapy.9

Delayed union and nonunion of the navicular may require surgical intervention. A variety of techniques have been used for repair. These include (1) curettage and bone grafting, (2) internal fixation, (3) excision of the symptomatic ossicles, or (4) a combination of these techniques.

Other Treatment (Injection, manipulation, etc.)

A custom-molded orthotic with longitudinal and transverse arch support may be prescribed to help relieve stress on the navicular during this transition phase.

Maintenance Phase

Rehabilitation Program

Physical Therapy

In the maintenance phase, the athlete must adhere to the general guidelines that are indicated for preventing stress fractures. A constant level of daily activity should be maintained, and the athlete should increase or decrease this level only gradually. The athlete should initiate new activities and sports in the same gradual manner.

Medical Issues/Complications

As outlined in the Clinical, Causes section, an attempt should be made to identify a precipitating event or defect in training that contributed to the stress fracture.

Medication

As with all fractures, pain management should be a primary concern. Often, acetaminophen or an NSAID (eg, ibuprofen) suffices for the acute pain of a navicular stress fracture because immobilization and rest should considerably improve the pain. Moreover, the persistence of pain, especially in the recovery phase, is an important sign that healing has not occurred and the fracture is still present. However, additional pain relief should not be withheld if the patient does not have relief with acetaminophen or NSAIDs alone. In this case, an opiate (eg, oxycodone) may be required, particularly for breakthrough pain. Adjustment of pain medications may be necessary, especially in the acute phase.

Related eMedicine topics:
 Opioid Abuse
Toxicity, Acetaminophen
Toxicity, Narcotics
Toxicity, Nonsteroidal Anti-inflammatory Agents

Related Medscape topics:
Resource Center Pain Management: Advanced Approaches to Chronic Pain Management 
Resource Center Pain Management: Pharmacologic Approaches
CME Integrating Ongoing Research and Knowledge into the Clinical Management of Chronic Pain
CME Overcoming Barriers to Pain Relief: An Interactive Patient Case Symposium
CME/CE Use of Multiple NSAIDs Reduces Arthritis Pain but May Increase Complications

Analgesics

Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma.


Acetaminophen (Tylenol, Feverall, Tempera, Aspirin-Free Anacin)

Indicated for mild to moderate pain. DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.

Adult

325-650 mg PO q4-6h or 1000 mg tid/qid; not to exceed 4 g/d

Pediatric

<12 years: 10-15 mg/kg/dose PO q4-6h prn; not to exceed 2.6 g/d

>12 years: 325-650 mg PO q4h; not to exceed 5 doses in 24 h

Rifampin can reduce analgesic effects; coadministration with barbiturates, carbamazepine, hydantoins, and isoniazid may increase hepatotoxicity.

Documented hypersensitivity; known G6PD deficiency

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

Precautions

Hepatotoxicity is possible in patients with chronic alcoholism following various dose levels; severe or recurrent pain or high or continued fever may indicate a serious illness; acetaminophen is contained in many OTC products, and combined use with these products may result in cumulative acetaminophen doses that exceed the recommended maximum dose.


Ibuprofen (Motrin, Ibuprin)

DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Adult

400-600 mg PO q4-6h while symptoms persist; not to exceed 3.2 g/d

Pediatric

<6 months: Not established

6 months to 12 years: 4-10 mg/kg/dose PO tid/qid

>12 years: Administer as in adults

Coadministration with aspirin increases the risk of inducing serious NSAID-related adverse effects; probenecid may increase the concentrations and, possibly, the toxicity of NSAIDs; may decrease the effect of hydralazine, captopril, and beta-blockers; may decrease the diuretic effects of furosemide and thiazides; may increase PT duration when taking anticoagulants (instruct patients to watch for signs of bleeding); may increase the risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently

Documented hypersensitivity; in the presence of peptic ulcer disease, recent GI bleeding or perforation, renal insufficiency, or high risk of bleeding

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

Caution in patients with congestive heart failure, hypertension, and decreased renal and hepatic function; caution in the presence of anticoagulation abnormalities or during anticoagulant therapy


Oxycodone (OxyContin, OxyIR, Roxicodone)

Indicated for moderate to severe pain.

Adult

5-30 mg PO q4h prn

Pediatric

0.05-0.15 mg/kg/dose PO; not to exceed 5 mg/dose PO q4-6h prn

Phenothiazines may decrease the analgesic effects; toxicity increases with coadministration of either CNS depressants or TCAs

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Duration of action may increase in elderly persons; be aware of total daily dose of acetaminophen, and do not exceed 4 g/d, because higher doses may cause liver toxicity.

More on Navicular Fracture

Overview: Navicular Fracture
Differential Diagnoses & Workup: Navicular Fracture
Treatment & Medication: Navicular Fracture
Follow-up: Navicular Fracture
Multimedia: Navicular Fracture
References
[ CLOSE WINDOW ]

References

  1. Thordarson DB. Fractures of the midfoot and forefoot. In: Myerson MS, Leonard ME, eds. Foot and Ankle Disorders. 2nd ed. Orlando, Fla: Harcourt; 2000:1265-85.

  2. Dunjey M. Stress fractures in athletes. Department of Podiatry Encyclopedia. Perth, Australia: Curtln Health Science, Curtin University. 1999;1-14.

  3. Ho K, Abu-Laban RB. Ankle and foot. In: Rosen P, Barkin RM, eds. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St Louis, Mo: Mosby-Year Book; 1998:836-56.

  4. Marder RA, Lian GJ, eds. Midfoot: tarsal navicular stress fracture. Sports Injuries of the Ankle and Foot. New York, NY: Springer-Verlag; 1997:64-8.

  5. Heckman JD. Fractures and dislocations of the foot. In: Rockwood CA, Green DP, eds. Rockwood and Green's Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1996:2355-62.

  6. Sangeorzan BJ, Benirschke SK, Mosca V, Mayo KA, Hansen ST Jr. Displaced intra-articular fractures of the tarsal navicular. J Bone Joint Surg Am. Dec 1989;71(10):1504-10. [Medline]. [Full Text].

  7. Towne LC, Blazina ME, Cozen LN. Fatigue fracture of the tarsal navicular. J Bone Joint Surg Am. Mar 1970;52(2):376-8. [Medline]. [Full Text].

  8. Torg JS, Pavlov H, Cooley LH, et al. Stress fractures of the tarsal navicular. A retrospective review of twenty-one cases. J Bone Joint Surg Am. Jun 1982;64(5):700-12. [Medline]. [Full Text].

  9. Saxena A, Fullem B. Navicular stress fractures: a prospective study on athletes. Foot Ankle Int. Nov 2006;27(11):917-21. [Medline].

  10. Cohen M, Roman A, Lovins JE. Totally implanted direct current stimulator as treatment for a nonunion in the foot. J Foot Ankle Surg. Jul-Aug 1993;32(4):375-81. [Medline].

  11. Samoladas E, Fotiades H, Christoforides J, Pournaras J. Talonavicular dislocation and nondisplaced fracture of the navicular. Arch Orthop Trauma Surg. Feb 2005;125(1):59-61. [Medline].

  12. Pinney SJ, Sangeorzan BJ. Fractures of the tarsal bones. Orthop Clin North Am. Jan 2001;32(1):21-33. [Medline].

  13. Garland DE, Moses B, Salyer W. Long-term follow-up of fracture nonunions treated with PEMFs. Contemp Orthop. Mar 1991;22(3):295-302. [Medline].

  14. Fitch KD, Blackwell JB, Gilmour WN. Operation for non-union of stress fracture of the tarsal navicular. J Bone Joint Surg Br. Jan 1989;71(1):105-10. [Medline]. [Full Text].

  15. Orava S, Hulkko A. Delayed unions and nonunions of stress fractures in athletes. Am J Sports Med. Jul-Aug 1988;16(4):378-82. [Medline].

  16. Rymaszewski LA, Robb JE. Mechanism of fracture-dislocation of the navicular: brief report. J Bone Joint Surg Br. May 1988;70(3):492. [Medline]. [Full Text].

  17. Coughlin L, Kwok D, Oliver J. Fracture dislocation of the tarsal navicular. A case report. Am J Sports Med. Nov-Dec 1987;15(6):614-5. [Medline].

  18. Wall J, Feller JF. Imaging of stress fractures in runners. Clin Sports Med. Oct 2006;25(4):781-802. [Medline].

  19. Lee S, Anderson RB. Stress fractures of the tarsal navicular. Foot Ankle Clin. Mar 2004;9(1):85-104. [Medline].

  20. Craig JG, Jacobson JA, Moed BR. Ultrasound of fracture and bone healing. Radiol Clin North Am. Jul 1999;37(4):737-51, ix. [Medline].

  21. Knapp TP, Garrett WE Jr. Stress fractures: general concepts. Clin Sports Med. Apr 1997;16(2):339-56. [Medline].

  22. Arendt EA, Griffiths HJ. The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes. Clin Sports Med. Apr 1997;16(2):291-306. [Medline].

  23. Alfred RH, Belhobek G, Bergfeld JA. Stress fractures of the tarsal navicular. A case report. Am J Sports Med. Nov-Dec 1992;20(6):766-8. [Medline].

  24. Kiss ZS, Khan KM, Fuller PJ. Stress fractures of the tarsal navicular bone: CT findings in 55 cases. AJR Am J Roentgenol. Jan 1993;160(1):111-5. [Medline]. [Full Text].

  25. Bennell KL, Malcolm SA, Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive track and field athletes. A twelve-month prospective study. Am J Sports Med. Mar-Apr 1996;24(2):211-7. [Medline].

  26. Bennell KL, Malcolm SA, Thomas SA, et al. Risk factors for stress fractures in track and field athletes. A twelve-month prospective study. Am J Sports Med. Nov-Dec 1996;24(6):810-8. [Medline].

  27. Rome K, Handoll HH, Ashford R. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database Syst Rev. 2005;2:CD000450. [Medline].

  28. Brukner P, Bradshaw C, Khan KM, White S, Crossley K. Stress fractures: a review of 180 cases. Clin J Sport Med. Apr 1996;6(2):85-9. [Medline].

  29. Khan KM, Fuller PJ, Brukner PD, Kearney C, Burry HC. Outcome of conservative and surgical management of navicular stress fracture in athletes. Eighty-six cases proven with computerized tomography. Am J Sports Med. Nov-Dec 1992;20(6):657-66. [Medline].

  30. Ting A, King W, Yocum L, et al. Stress fractures of the tarsal navicular in long-distance runners. Clin Sports Med. Jan 1988;7(1):89-101. [Medline].

  31. Sanders TG, Williams PM, Vawter KW. Stress fracture of the tarsal navicular. Mil Med. Jul 2004;169(7):viii-xiii. [Medline].

  32. Armstrong DW 3rd, Rue JP, Wilckens JH, Frassica FJ. Stress fracture injury in young military men and women. Bone. Sep 2004;35(3):806-16. [Medline].

  33. Bennell KL, Brukner PD. Epidemiology and site specificity of stress fractures. Clin Sports Med. Apr 1997;16(2):179-96. [Medline].

  34. Macintyre J, Joy E. Foot and ankle injuries in dance. Clin Sports Med. Apr 2000;19(2):351-68. [Medline].

  35. Knapp T, Mandelbaum B, Garrett W Jr. Why are stress injuries so common in the soccer player?. Clin Sports Med. Oct 1998;17(4):835-53.

  36. Zetaruk MN. The young gymnast. Clin Sports Med. Oct 2000;19(4):757-80. [Medline].

  37. Bennell KL, Malcolm SA, Wark JD, Brukner PD. Skeletal effects of menstrual disturbances in athletes. Scand J Med Sci Sports. Oct 1997;7(5):261-73. [Medline].

  38. Borges JL, Guille JT, Bowen JR. Köhler's bone disease of the tarsal navicular. J Pediatr Orthop. Sep-Oct 1995;15(5):596-8. [Medline].

  39. Ippolito E, Ricciardi Pollini PT, Falez' F. Köhler's disease of the tarsal navicular: long-term follow-up of 12 cases. J Pediatr Orthop. Aug 1984;4(4):416-7. [Medline].

  40. Williams GA, Cowell HR. Köhler's disease of the tarsal navicular. Clin Orthop Relat Res. Jul-Aug 1981;158:53-8. [Medline].

  41. Staheli LT. Planovalgus foot deformity. Current status. J Am Podiatr Med Assoc. Feb 1999;89(2):94-9. [Medline].

  42. Saxena A, Fullem B, Hannaford D. Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification system. J Foot Ankle Surg. Mar-Apr 2000;39(2):96-103. [Medline].

  43. Diehl JJ, Best TM, Kaeding CC. Classification and return-to-play considerations for stress fractures. Clin Sports Med. Jan 2006;25(1):17-28, vii. [Medline].

  44. Brukner P, Bradshaw C, Bennell K. Managing common stress fractures: let risk level guide treatment. Phys Sportsmed [serial online]. Aug 1998;26(8):Accessed February 8, 2008. Available at www.physsportsmed.com/issues/1998/08aug/brukner.htm.

  45. Potter NJ, Brukner PD, Makdissi M, et al. Navicular stress fractures: outcomes of surgical and conservative management. Br J Sports Med. Aug 2006;40(8):692-5; discussion 695. [Medline].

  46. Raasch WG, Hergan DJ. Treatment of stress fractures: the fundamentals. Clin Sports Med. Jan 2006;25(1):29-36, vii. [Medline].

  47. Trock DH. Electromagnetic fields and magnets. Investigational treatment for musculoskeletal disorders. Rheum Dis Clin North Am. Feb 2000;26(1):51-62, viii. [Medline].

  48. Scott G, King JB. A prospective, double-blind trial of electrical capacitive coupling in the treatment of non-union of long bones. J Bone Joint Surg Am. Jun 1994;76(6):820-6. [Medline]. [Full Text].

  49. Gossling HR, Bernstein RA, Abbott J. Treatment of ununited tibial fractures: a comparison of surgery and pulsed electromagnetic fields (PEMF). Orthopedics. Jun 1992;15(6):711-9. [Medline].

  50. Gillespie WJ, Grant I. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database Syst Rev. 2000;2:CD000450. [Medline].

  51. Brukner P, Bennell K. Overuse injuries: where to now?. Br J Sports Med. Mar 1997;31(1):2. [Medline].

  52. Bruns W, Maffulli N. Lower limb injuries in children in sports. Clin Sports Med. Oct 2000;19(4):637-62. [Medline].

  53. DiGiovanni CW, Patel A, Calfee R, Nickisch F. Osteonecrosis in the foot. J Am Acad Orthop Surg. Apr 2007;15(4):208-17. [Medline].

  54. Hochman MG, Min KK, Zilberfarb JL. MR imaging of the symptomatic ankle and foot. Orthop Clin North Am. Oct 1997;28(4):659-83. [Medline].

  55. Hoffinger SA. Evaluation and management of pediatric foot deformities. Pediatr Clin North Am. Oct 1996;43(5):1091-111. [Medline].

  56. Hunter LY. Stress fracture of the tarsal navicular. More frequent than we realize?. Am J Sports Med. Jul-Aug 1981;9(4):217-9. [Medline].

  57. Isikan UE. The values of talonavicular angles in patients with pes planus. J Foot Ankle Surg. Sep-Oct 1993;32(5):514-6. [Medline].

  58. Khan KM, Brukner PD, Kearney C, et al. Tarsal navicular stress fracture in athletes. Sports Med. Jan 1994;17(1):65-76. [Medline].

  59. Lyon RM, Street CC. Pediatric sports injuries: when to refer or x-ray. Pediatr Clin North Am. Feb 1998;45(1):221-44. [Medline].

  60. Maitra RS, Johnson DL. Stress fractures. Clinical history and physical examination. Clin Sports Med. Apr 1997;16(2):259-74. [Medline].

  61. Manusov EG, Lillegard WA, Raspa RF, Epperly TD. Evaluation of pediatric foot problems: part I. The forefoot and the midfoot. Am Fam Physician. Aug 1996;54(2):592-606. [Medline].

  62. Omey ML, Micheli LJ. Foot and ankle problems in the young athlete. Med Sci Sports Exerc. Jul 1999;31(7 suppl):S470-86. [Medline].

  63. Orava S, Karpakka J, Hulkko A, Takala T. Stress avulsion fracture of the tarsal navicular. An uncommon sports-related overuse injury. Am J Sports Med. Jul-Aug 1991;19(4):392-5. [Medline].

  64. Simons SM. Foot injuries of the recreational athlete. Phys Sportsmed [serial online]. Jan 1999;27(1):Accessed February 11, 2008. Available at http://www.physsportsmed.com/issues/1999/01_99/simons.htm.

  65. Thordarson DB. Detecting and treating common fractures of the foot and ankle: part 2: the midfoot and forefoot. Phys Sportsmed [serial online]. Oct 1996;24(10):Available at http://www.physsportsmed.com/issues/1996/10_96/thordar2.htm.

  66. Wedmore IS, Charette J. Emergency department evaluation and treatment of ankle and foot injuries. Emerg Med Clin North Am. Feb 2000;18(1):85-113, vi. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

tarsal navicular fracture, midfoot fracture, mid-foot fracture, navicular stress fracture, navicular stress fractures, navicular cortical avulsion fracture, navicular tuberosity fracture, navicular body fracture, heel fracture, foot fracture, broken foot, navicular bone fracture, foot pain, N-spot, N spot

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Michael J Ameres, MD, Consulting Staff, Department of Emergency Medicine, Southampton Hospital
Michael J Ameres, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Greg Montalbano, MD, Assistant Clinical Professor, Department of Orthopaedics, New York University Medical School
Greg Montalbano, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Sierra Cascade Trauma Society
Disclosure: Nothing to disclose.

Rafat Farouqui, MBBS, Consulting Staff, Department of Orthopedic Surgery, Brooklyn Hospital Center
Disclosure: Nothing to disclose.

Benson Yeh, MD, Assistant Program Director, Department of Emergency Medicine, Brooklyn Hospital Center; Clinical Instructor, Department of Medicine, Division of Emergency Medicine, Cornell University
Benson Yeh, MD is a member of the following medical societies: Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Andrew L Sherman, MD, Assistant Professor, Departments of Neurological Surgery, Orthopedics, and Rehabilitation, University of Miami
Andrew L Sherman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Sports Medicine, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.