Navicular Fracture

(Tarsal Navicular Fracture)

by Krisha McCoy, MS

Definition

A 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

Causes

A 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 Factors

Factors that may increase the chance of a navicular fracture include:

Trauma
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

Symptoms

Navicular fracture may cause:

Vague, aching pain in the top, middle portion of the foot, which may radiate along the 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

Diagnosis

Your 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:

Treatment

Talk with the doctor about the best treatment plan. Treatment options include:

Nonsurgical Treatment

Most cases of navicular fracture respond well to being placed in a cast that holds the bones in place. Crutches will be needed to help with walking. Once the bone has healed, a rehabilitation program can help with the return to normal activities.

Surgery

In 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.

Prevention

To 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.

RESOURCES:

Foot Care MD—American Orthopaedic Foot & Ankle Society
http://www.aofas.org/footcaremd/Pages/footcaremd.aspx

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/patient/public-information.html

When it Hurts to Move—Canadian Orthopaedic Foundation
http://whenithurtstomove.org

References:

Coris EE, Lombardo JA. Tarsal navicular stress fractures. Am Fam Physician. 2003;67(1):85-91.

Stress fractures of the foot and ankle. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated March 2015. Accessed August 30, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 9/30/2013

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