II. Mechanism
- Concurrent Fracture dislocation (high energy injury)
- Talocalcaneonavicular joint
- Calcaneocuboid joint
- Naviculocuneiform joint
- Avulsion Fracture (50% of Navicular Fractures)
- Plantar flexion with inversion or eversion
- Tuberosity Fracture
- Eversion injury
- Navicular body Fracture
- Direct or axial load
- Stress Fracture
III. Imaging
- Weight-Bearing, Three View Foot XRay (AP, lateral, oblique)
- Obtain initial and again every 2 weeks until healed
- Monitor for nonunion
- Findings
- Avulsion Fracture
- Tuberosity Fracture
- Tarsal Navicular body Fracture
- Obtain initial and again every 2 weeks until healed
- Advanced imaging indications
- Tarsal Navicular Stress Fracture
- May be indicated per specialist recommendation to define Fracture lines and associated Soft Tissue Injury
IV. Management
- See Tarsal Navicular Stress Fracture
- Minor avulsion Fracture (low energy injury)
- Short Leg Walking Cast or boot for 4 to 6 weeks
- May switch to hard soled shoe at 4 weeks if healing on XRay and exam
- Navicular body Fracture
- Short Leg Walking Cast or boot for 6 to 8 weeks
- Significant injury with suspected Ligamentous Injury
- Non-weight bearing and splint
- Orthopedic or Podiatry referral
- Orthopedic or Podiatry Referral Indications
V. References
- Orman and Ramadorai in Herbert (2016) EM:Rap 16(12): 8-9
- Silver (2024) Am Fam Physician 109(2): 119-29 [PubMed]