Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Aug;40(8):692-5; discussion 695.
doi: 10.1136/bjsm.2005.022079. Epub 2006 Apr 12.

Navicular stress fractures: outcomes of surgical and conservative management

N J Potter  1 , P D Brukner, M Makdissi, K Crossley, Z S Kiss, C Bradshaw
Affiliations

Navicular stress fractures: outcomes of surgical and conservative management

N J Potter et al. Br J Sports Med. 2006 Aug.

Abstract

Objective: To compare the long term outcomes of the two treatment options for navicular stress fractures: non-weightbearing cast immobilisation and surgical fixation.

Design: Retrospective case study.

Participants: Subjects aged 18 years and older who had been treated for a navicular stress fracture more than two years previously.

Main outcome measures: Questionnaire based analogue pain score and function score; tenderness on palpation; abnormality detected on computed tomography (CT).

Results: In all, 32 fractures in 26 subjects were investigated. No significant differences were found between surgical and conservative management for current pain (p = 0.984), current function (p = 0.170), or abnormality on CT (p = 0.173). However, surgically treated patients more often remained tender over the "N spot" (p = 0.005), even after returning to competition for two years or more.

Conclusions: Surgical fixation of navicular stress fractures appears to be as effective as conservative management over the longer term. However, there remains a small but measurable degree of pain and loss of function over this period. The value of using "N spot" tenderness as the sole clinical predictor of treatment success requires further investigation, as some patients remained tender despite successful completion of treatment and return to competition.

PubMed Disclaimer

References

    1. Towne L C, Blazina M E, Cozen L N. Fatigue fracture of the tarsal navicular. J Bone Joint Surg Am 197052376–378. - PubMed
    1. Khan K M, Brukner P D, Kearney C.et al Tarsal navicular stress fracture in athletes. Sports Med 19941765–76. - PubMed
    1. Bennell K L, Malcolm S A, Thomas S A.et al The incidence and distribution of stress fractures in competitive track and field athletes. A twelve‐month prospective study. Am J Sports Med 199624211–217. - PubMed
    1. Brukner P, Bradshaw C, Khan K M.et al Stress fractures: a review of 180 cases. Clin J Sports Med 1996685 - PubMed
    1. Torg J S, Pavlov H, Cooley L H.et al Stress fractures of the tarsal navicular: a retrospective review of 21 cases. J Bone Joint Surg Am 198264700–712. - PubMed