Submitted By David A. Porter M.D. PhD.
10.13.2008

In the July 2008 issue of Techniques in Foot & Ankle Surgery, with the help of Jennifer Torma, I published an article called “Surgical Technique for Navicular Stress Fractures in Athletes.” 

Navicular stress fractures are being diagnosed more frequently in athletes involved in sports that require running and jumping.  The athlete with a navicular stress fracture often presents with vague foot pain, arch pain, anterior ankle pain or medial foot pain. However, typically there is not one incident that the athlete recalls that might have caused this discomfort. The only way to classify the fracture is through an MRI or bone scan, with a CAT scan used to classify the fix and follow the patient’s course of healing.

This type of fracture was first diagnosed in 1970 and historically, six weeks of non-weight bearing in a cast has been the recommended treatment for this injury. During the past few decades though, reported treatment options have varied, and reports have shown that the recommended treatment may not be the treatment actually undertaken in practice.  Recently, there has been a trend toward more aggressive surgical treatment.  The injury can be very debilitating, and highly competitive athletes who most often sustain this stress fracture seek treatment that will return them quickly but safely to their sport.  The purpose of this article was to report a surgical technique for this stress fracture, screw fixation, and report the outcomes of a series of patients who have undergone this procedure.

According to our review, 70 percent of athletes can heal with non-operative treatments, such as non-weight bearing in a cast for six weeks.  However, 90 percent of athletes heal with the surgical techniques described in conjunction with the non-weight bearing technique.  We will continue to research the navicular stress fracture so athletes can get diagnosed quicker and heal more effectively.