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Stress avulsion fracture of the tarsal navicular

An uncommon sports-related overuse injury

Department of Sports Medicine, Deaconess Institute of Oulu and University of Oulu, Finland

Jarmo Karpakka, MD

Department of Sports Medicine, Deaconess Institute of Oulu and University of Oulu, Finland

Antero Hulkko, MD

Department of Surgery, Keski-Pohjanmaa Central Hospital, Kokkola, Finland

Timo Takala, MD

Department of Sports Medicine, Deaconess Institute of Oulu and University of Oulu, Finland

We report nine cases of stress-related avulsion fracture of the tarsal navicular in athletes. This uncommon over use injury is thought to occur following repetitive cyclic compressive loading secondary to an impingement of the tarsal navicular. The small dorsal triangular frag ment is best seen in weightbearing lateral view radio graphs and isotope scan and/or tomography help con firm the diagnosis. We feel that operative treatment is the method of choice in highly symptomatic cases and among top athletes because of the shorter recovery time.