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Tarsal navicular stress fractures.
Rachel J Shakked1, Emily E Walters2, Martin J O'Malley3
1Rothman Institute, 3300 Tillman Drive, 2nd Floor, Bensalem, PA, 19020-2071, USA. Rachel.shakked@rothmaninstitute.com.
Current Reviews in Musculoskeletal Medicine
|January 23, 2017
Summary
Navicular stress fractures in athletes require careful management. This review covers evaluation and treatment options, including surgery for faster return to sports.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Bone healing
Background:
- Navicular stress fractures are a frequent injury in athletic populations.
- Optimal management strategies for these fractures remain a subject of ongoing discussion.
Purpose of the Study:
- To comprehensively review the current evaluation and management protocols for navicular stress fractures.
- To present an evidence-based treatment algorithm for athletic patients.
Main Methods:
- Review of current literature on operative and non-operative treatment modalities.
- Discussion of adjunctive therapies such as vitamin D, shock wave therapy, bone marrow aspirate concentrate (BMAC), and teriparatide.
- Presentation of a preferred treatment algorithm with illustrative images.
Main Results:
- Various adjunctive treatments, including vitamin D, shock wave therapy, BMAC, and teriparatide, are discussed.
- Surgical intervention may facilitate an earlier return to athletic participation.
- A proposed treatment algorithm aims for safe and expedited return to activity.
Conclusions:
- Further research is warranted to investigate the preventative role of vitamin D.
- Additional studies are needed to assess the efficacy of various adjunctive treatments in improving fracture healing rates.
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