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Non-stress fractures of the tarsal (foot) navicular

Authors
Anthony Beutler, MD
Cole Taylor, MD
Shane L Larson, MD
Section Editors
Patrice Eiff, MD
Chad A Asplund, MD, FACSM, MPH
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

Midfoot injuries are relatively uncommon, but the majority involve a combination of fractures and ligament injuries. The tarsal navicular bone is the keystone of the medial column of the foot, bearing the majority of the load applied to the tarsal complex during weight-bearing [1]. Acute fractures of the tarsal navicular are uncommon, and isolated fractures are even more uncommon, as tarsal navicular injury is typically associated with other fractures, dislocations, or soft tissue injuries of the foot.

The presentation, diagnosis, and management of acute tarsal navicular fractures is reviewed here. Stress fractures of the navicular are discussed separately as are other foot and lower extremity injuries. (See "Stress fractures of the tarsal (foot) navicular" and "Tarsometatarsal (Lisfranc) joint complex injuries" and "Metatarsal shaft fractures" and "Proximal fifth metatarsal fractures" and "Talus fractures" and "Calcaneus fractures" and "Evaluation and diagnosis of common causes of foot pain in adults" and "Fibula fractures" and "Overview of ankle fractures in adults".)

EPIDEMIOLOGY

Midfoot injuries comprise approximately 5 percent of all foot injuries [2-4]. The majority of midfoot injuries are combined injuries stemming from high-energy trauma and involve both osseous and ligamentous structures. Typically, midfoot injuries involve multiple fractures or fracture dislocations. Up to 30 percent of midfoot injuries are missed primarily or treated in a delayed manner, and these have poorer outcomes compared to injuries identified early and managed appropriately [5].

Navicular fractures are frequently associated with other fractures, dislocations, or ligament injuries and may result in considerable long-term disability. Stress fractures of the navicular are more common, comprising 14 percent of all stress fractures [6,7].

CLINICAL ANATOMY

Foot anatomy is reviewed in detail separately; aspects of that anatomy of particular relevance to navicular fractures are discussed below. (See "Evaluation and diagnosis of common causes of foot pain in adults", section on 'Anatomy and biomechanics'.)

           

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 15 00:00:00 GMT+00:00 2016.
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