Functional outcome and complications after surgical treatment of acute navicular fractures

Long-term functional outcome and complications following ORIF (Open Reduction Internal Fixation) for acute navicular fractures remain insufficiently investigated. This study aimed to evaluate functional outcome, complications, quality of life, and patient satisfaction after surgical treatment of acute navicular fractures.

This retrospective study was conducted at a level 1 trauma center, reviewing patients > 17 years with navicular fractures operated between 2010 and 2023. Functional outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score, the Foot Function Index (FFI), and EQ-5D quality of life questionnaire. Complications, such as nonunion, infection and secondary arthrodesis were recorded. A systematic literature review of studies published between 2000 and 2024 was performed.

The cohort included 24 females and 22 males with a median age of 35.9 years and mean follow-up of 69.0 (SD 42.6) months. The majority of patients (n = 44) underwent ORIF, union occurred in 43 patients, three patients had postoperative infection and five patients required secondary arthrodesis. Functional outcome was good (median AOFAS 80.0, median FFI 21.0).

Surgical treatment of acute navicular fractures, primarily ORIF using miniplate fixation, resulted in successful union with overall good functional outcome. Nevertheless, residual problems such as painful osteoarthritis and functional limitations, especially in type 2 and 3 injuries, could be expected.

III.