Isolated dorsal fracture-dislocation of the tarsal navicular

Vaishya, Raju; Patrick, J.

doi:10.1016/0020-1383(91)90162-8

Cited by 35 publications

(26 citation statements)

References 3 publications

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“…8 The rarity of this injury can be attributed to this rigid bony and ligamentous support surrounding the navicular, which usually undergoes fracture and dislocation rather than pure dislocation. 1 Since the foot is composed of two longitudinal columns, the lateral and the medial, each adding to the stability of the other, there must be break in both columns for the navicular to dislocate completely without fracture.…”

Section: Discussionmentioning

confidence: 99%

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Management of complete dislocation of tarsal scaphoid without fracture

2017

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Background: Injuries to the mid tarsal joints usually occur in the form of various combinations such as fracture, fracture subluxation, and fracture dislocation. Dislocations of navicular without fracture are rare injuries, minimal literatures exist, which describe the probable mechanism of injury and optimal treatment.Methods: Four patients with complete dislocation of navicular without fracture presented to us following a history of trauma. The diagnosis was confirmed by radiology and further details were studied by CT scans. One injury was open and the rest were closed. One had associated fracture of talus and two had metatarsal fracture and one was purely isolated navicular dislocation without any associated injury. All were initially stabilized in a below knee plaster of paris slab and foot end elevated. All were successfully treated surgically under spinal anesthesia with open reduction and internal fixation with Kirschner wires through a dorsomedial approach. Postoperative immobilization was continued for twelve weeks then gradual mobilization begun followed by physiotherapy.Results: All patients had good clinical results with two patients resuming their work within twelve weeks and the one with open wound took twenty weeks for resuming his original work. One with associated talar fracture later had to undergo subtalar arthrodesis for pain in the foot while weight bearing after one year of surgery for navicular dislocation. Conclusions: Open reduction and internal fixation with Kirschner wire is an effective way of managing patients with complete dislocation of tarsal navicular for early resuming of the functions and return to work.

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Section: Discussionmentioning

confidence: 99%

“…Pure navicular dislocation is a very rare injury with only few cases reported. [1][2][3][4][5][6] Because of this rarity, its mechanism of injury is poorly understood and its optimum treatment plan could not be worked out.…”

Section: Introductionmentioning

confidence: 99%

Management of complete dislocation of tarsal scaphoid without fracture

2017

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“…1 This makes it very rare to have pure dislocation rather than fracture-dislocation. 10,11 Till now, only 16 published case reports have been mentioned in literature and earliest published case was reported in 1924. 9 According to Dhillon et al, 2,5 a navicular dislocation can not occur without bony or ligamentous damage to longitudinal columns of foot.…”

Section: Discussionmentioning

confidence: 99%

“…1 Isolated dislocation of this bone is a very rare incidence. 2e9 Usually it is associated with fracture of navicular 10,11 itself or along with others bones of foot. 12e14 Mechanism of injury is believed to be the result of a severe abduction force with the foot in plantar flexion, rather than the previously described medial swivel dislocation, which typically involves the subtalar joint.…”

Section: Introductionmentioning

confidence: 99%

An isolated dorso-medial dislocation of navicular bone: A case report

Singh

Kashyap

Vargaonkar

et al. 2015

Journal of Clinical Orthopaedics and Trauma

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“…3 This usually occurs when an element of longitudinally directed force compresses the navicular, in addition to an abduction/plantar flexion injury. 4 Isolated dislocations without fractures of the body are extremely rare, and it has been claimed that dislocation without fracture is an anatomical impossibility 5 since the foot is composed of two longitudinal columns, the lateral and the medial, each adding to the stability of the other. Consequently, for the navicular to dislocate completely without fracture, there must be a break in both columns, with marked instability.…”

mentioning

confidence: 99%

Total dislocations of the navicular: are they ever isolated injuries?

Dhillon

Nagi

1999

The Journal of Bone and Joint Surgery. British volume

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Isolated dislocations of the navicular are rare injuries; we present our experience of six cases in which the navicular was dislocated without fracture. All patients had complex injuries, with considerable disruption of the midfoot. Five patients had open reduction and stabilisation with Kirschner wires. One developed subluxation and deformity of the midfoot because of inadequate stabilisation of the lateral column, and there was one patient with ischaemic necrosis. We believe that the navicular cannot dislocate in isolation because of the rigid bony supports around it; there has to be significant disruption of both longitudinal columns of the foot. Most commonly, an abduction/pronation injury causes a midtarsal dislocation, and on spontaneous reduction the navicular may dislocate medially. This mechanism is similar to a perilunate dislocation. Stabilisation of both medial and lateral columns of the foot may sometimes be essential for isolated dislocations. In spite of our low incidence of ischaemic necrosis, there is always a likelihood of this complication. Midtarsal injuries are the result of complex multidirectional forces.1 The bones of the midfoot fit snugly to one another and are shaped to form transverse and longitudinal arches. The navicular, the keystone of the medial longitudinal arch, is rigidly stabilised by an extensive network of dorsal and plantar ligaments. 2 Because of the strong ligamentous attachments and the recessed position of the navicular, fractures are much more common than dislocations. The usual mechanism is a plantar flexion/compressive injury, which crushes the bone and may sometimes displace a part of the fractured bone from the naviculocuneiform and the talonavicular joints. 3 This usually occurs when an element of longitudinally directed force compresses the navicular, in addition to an abduction/plantar flexion injury. 4 Isolated dislocations without fractures of the body are extremely rare, and it has been claimed that dislocation without fracture is an anatomical impossibility 5 since the foot is composed of two longitudinal columns, the lateral and the medial, each adding to the stability of the other. Consequently, for the navicular to dislocate completely without fracture, there must be a break in both columns, with marked instability. We have reviewed all patients seen at our institute in whom the navicular was found to be dislocated without a fracture of the body, in order to analyse the mechanism and forces involved. A review of the literature from 1920 onwards revealed only six cases of either total or isolated dislocations of the navicular.

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Isolated dorsal fracture-dislocation of the tarsal navicular

Cited by 35 publications

References 3 publications

Management of complete dislocation of tarsal scaphoid without fracture

Management of complete dislocation of tarsal scaphoid without fracture

An isolated dorso-medial dislocation of navicular bone: A case report

Total dislocations of the navicular: are they ever isolated injuries?

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