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Navicular Fracture

(Tarsal Navicular Fracture)

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

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Causes    TOP

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    TOP

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

Symptoms    TOP

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    TOP

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    TOP

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    TOP

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:

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:
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Updated March 2015. Accessed August 30, 2017.
Last reviewed August 2017 by EBSCO Medical Review BoardWarren A. Bodine, DO, CAQSM
Last Updated: 9/30/2013

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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