Navicular Fracture Follow-up

Updated: May 18, 2017
  • Author: Michael J Ameres, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Follow-up

Return to Play

After 6 weeks of not bearing weight on the injured foot, the patient is assessed for pain at the N spot. If the patient is free from pain, a gradual return to normal activity is begun. This gradual return should be in a stepwise fashion over 6 weeks. The specifics of this regimen are discussed under Physical therapy in the Recovery Phase, Rehabilitation Program section, above.

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Complications

The complications of a navicular stress fracture can include delayed union, nonunion, and progression to overt fracture-dislocation. [11, 12, 13, 14, 15, 16, 17, 18] Any of these complications can lead to prolonged disability and/or arthritis of the talonavicular joint. Up to 14% of patients treated correctly do not return to previous activities. Often, these complications require surgical intervention.

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Prevention

In general, proper and well-fitting equipment, a gradual increase in activities, and a gradual approach to new activities limit the risk of stress fractures. Shock-absorbing inserts in footwear may reduce the incidence of lower-extremity stress fractures in military recruits. [28, 58]

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Prognosis

Using the aforementioned stepwise regimen of 6 weeks of not bearing weight on the injured foot, followed by a gradual return to normal activity (see Physical therapy in the Recovery Phase, Rehabilitation Program section, above), one can expect 86% of patients who receive such treatment to return to normal activity.

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Patient Education

Importantly, recognize that navicular stress fractures can occur in a wide range of athletes in many different sports, and that the diagnosis is made based on clinical considerations, positive bone scan findings, and confirmatory CT scan findings. However, once the diagnosis is made, non–weight-bearing treatment often results in full recovery.

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