J Korean Foot Ankle Soc.  2016 Dec;20(4):170-175. 10.14193/jkfas.2016.20.4.170.

The Operative Management of Navicular Stress Fractures in Adolescence

• Lee KT
• Kim KC
• Young KW
• Cho CH

• KMID: 2362765
• DOI: http://doi.org/10.14193/jkfas.2016.20.4.170

Abstract

PURPOSE
The aim of this study is to evaluate the effectiveness of surgical treatment in adolescent patients suffering from navicular stress fracture.
MATERIALS AND METHODS
A total of 11 adolescent patients aged 14 to 19, who underwent an operation for navicular stress fracture between 2005 and 2008 were recruited. Clinical outcomes were evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score and visual analogue scale (VAS) score.
RESULTS
The mean VAS score before the operation was 7.7. A score of 2.9 was confirmed at final follow up after the operation. The mean final follow-up period was 22.1 months. There was a statistically significant improvement in the VAS score between before and after the operation (p=0.01), and similarly, the AOFAS score also showed an improvement, from 46.5 to 80.7 (p=0.01). The pain that remained after the operation, according to the VAS score, was severe in three patients (27.3%), tolerable in seven patients (63.6%), and free of pain in one patient (9.1%).
CONCLUSION
In navicular stress fracture in adolescents, careful selection of patients who could benefit from surgical treatment is recommended.

Keyword

Adolescence; Navicular bone; Stress fracture; Surgery

MeSH Terms

Adolescent*
Ankle
Follow-Up Studies
Foot
Fractures, Stress*
Humans

Figure

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  Figure 1. Magnetic resonance images are demonstrating type I navicular stress fracture (A), type II navicular stress fracture (B), and type III navicular stress fracture (C).

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  Figure 2. (A) Longitudinal incision was done over navicular body and explorated by needle insertion. (B) Sclerotic bone protuberance was resected. (C) Calcaneal anterior process strut bone graft was fit in ostectomy site.

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  Figure 3. Navicular bone fixated with a cannulated screw through medial to lateral side is observed in postoperative foot standing anteroposterior view (A) and lateral view (B).

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  Figure 4. Diffuse high signal over the navicular bone and ambiguous fracture line is observed.

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