Stress Fractures of the Navicular

Stress fractures of the navicular are a source of pain and disability in sports persons. The presenting symptoms and signs are often vague, which, when combined with limited radiographic evidence for fracture, can lead to a delay in diagnosis and treatment. Isotope bone scans and computerized tomography as useful in confirming the diagnosis and identifying the extent of the fracture lines.

Nonoperative treatment with 6-week non-weight-bearing in a cast is successful in achieving union in most cases. Operative intervention should be considered for extensive fractures through the full depth of the bone and for those with evidence for nonunion, although robust clinical evidence is limited. Contemporary operative treatment involves preparation of the fracture site, reduction, and bone grafting combined with cancellous screw fixation.