HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khan, K. M. Articles by Burry, H. C. Search for Related Content PubMed Articles by Khan, K. M. Articles by Burry, H. C.

Outcome of conservative and surgical management of navicular stress fracture in athletes

Eighty-six cases proven with computerized tomography

Olympic Park Sports Medicine Centre, Sports Medicine Centres of Victoria, Alphington Sports Medicine Clinic, Mercy Private Radiology and the Department of Medicine, University of Melbourne, Melbourne, Australia

Peter J. Fuller, MBBS, FASMF

Olympic Park Sports Medicine Centre, Sports Medicine Centres of Victoria, Alphington Sports Medicine Clinic, Mercy Private Radiology and the Department of Medicine, University of Melbourne, Melbourne, Australia

Peter D. Brukner, MBBS, FASMF, FACSM

Olympic Park Sports Medicine Centre, Sports Medicine Centres of Victoria, Alphington Sports Medicine Clinic, Mercy Private Radiology and the Department of Medicine, University of Melbourne, Melbourne, Australia

Chris Kearney, BEng

Olympic Park Sports Medicine Centre, Sports Medicine Centres of Victoria, Alphington Sports Medicine Clinic, Mercy Private Radiology and the Department of Medicine, University of Melbourne, Melbourne, Australia

Hugh C. Burry, FRCP, FRACP, FACRM

Olympic Park Sports Medicine Centre, Sports Medicine Centres of Victoria, Alphington Sports Medicine Clinic, Mercy Private Radiology and the Department of Medicine, University of Melbourne, Melbourne, Australia

Eighty-two athletes with 86 clinical navicular stress fractures, all imaged with computerized tomography, were followed for an average of 33 months (range, 6 to 108) after diagnosis. Initial treatment consisted of at least 6 weeks of nonweightbearing cast immobilization for 22 fractures, at least 6 weeks of limitation of activity with continued weightbearing for 34 fractures, and a period of less than 6 weeks of conservative treatment for another 19 fractures. Five patients attempted to continue playing sports. Six patients had immediate surgery.

Nineteen of 22 patients (86%) who had initial non weightbearing cast immobilization treatment returned to sports, compared with only 9 of 34 patients (26%) who initially continued weightbearing with limited activ ity (P < 0.001 ). After failure of the latter treatment, successful outcomes were seen for 6 of 7 patients (86%) treated with nonweightbearing cast immobiliza tion, while 11 of 15 patients (73%) who had one surgical procedure were able to return to sports.

These results indicate that nonweightbearing cast immobilization is the treatment of choice for navicular stress fractures. Also, this treatment compares favor ably with surgical treatment for patients who present after failed weightbearing treatments.

Computerized tomographic appearances of healing fractures do not necessarily mirror clinical union, and postimmobilization management should be monitored clinically.

This article has been cited by other articles:

				C. Shanmugam and N. Maffulli Sports injuries in children Br. Med. Bull., June 1, 2008; 86(1): 33 - 57. [Abstract] [Full Text] [PDF]

				M. H. Niva, M. J. Sormaala, M. J. Kiuru, R. Haataja, J. A. Ahovuo, and H. K. Pihlajamaki Bone Stress Injuries of the Ankle and Foot: An 86-Month Magnetic Resonance Imaging-based Study of Physically Active Young Adults Am. J. Sports Med., April 1, 2007; 35(4): 643 - 649. [Abstract] [Full Text] [PDF]

				G. M. Verrall, J. P. Slavotinek, G. T. Fon, and P. G. Barnes Outcome of Conservative Management of Athletic Chronic Groin Injury Diagnosed as Pubic Bone Stress Injury Am. J. Sports Med., March 1, 2007; 35(3): 467 - 474. [Abstract] [Full Text] [PDF]

				N J Potter, P D Brukner, M Makdissi, K Crossley, Z S Kiss, and C Bradshaw Navicular stress fractures: outcomes of surgical and conservative management * Commentary Br. J. Sports Med., August 1, 2006; 40(8): 692 - 695. [Abstract] [Full Text] [PDF]

				S. G. Burne, C. M. Mahoney, B. B. Forster, M. S. Koehle, J. E. Taunton, and K. M. Khan Tarsal Navicular Stress Injury: Long-term Outcome and Clinicoradiological Correlation Using Both Computed Tomography and Magnetic Resonance Imaging Am. J. Sports Med., December 1, 2005; 33(12): 1875 - 1881. [Abstract] [Full Text] [PDF]

				P Sharma, K. Luscombe, and N Maffulli Sports injuries in children Trauma, October 1, 2003; 5(4): 245 - 259. [Abstract] [PDF]

				B. P. Boden and D. C. Osbahr High-Risk Stress Fractures: Evaluation and Treatment J. Am. Acad. Ortho. Surg., November 1, 2000; 8(6): 344 - 353. [Abstract] [Full Text] [PDF]