Os Supranaviculare as a Predisposing Factor to Navicular Stress Fractures

Azawi, Doaa; Mahsouli, Amin; Vanhoenacker, Filip

doi:10.5334/jbsr.2666

Cited by 2 publications

(3 citation statements)

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“…However, there have been only a few reports on symptomatic OSSN, with or without NSF, other than case reports or small case series. 2,11,14 In one case series, it was not shown whether OSSNs had existed before the development of NSF. There is no consensus in the literature regarding the cause and treatment of symptomatic OSSN.…”

Section: Introductionmentioning

confidence: 98%

“…Ingalls et al 11 postulated that a dorsal cortical notch in the navicular bone due to the presence of OSSN may increase the likelihood of developing NSF and stated that this bony notch may act as a stress riser, increasing the shear stress on the dorsal surface of the navicular bone. 2,14 Many os subfibulare, one of the popular accessory bones of the foot and ankle, are the result of ankle sprains in childhood. 4 In other accessory bones, such as the os trigonum and os subtibiale, it is sometimes difficult to differentiate a real accessory bone from an avulsion fracture of the posterior talar process and the medial malleolus of the tibia.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of Symptomatic Os Supranaviculare in Athletes

Sugimoto,

Isomoto,

Miura

et al. 2024

Foot Ankle Int.

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Background: Although the incidence of os supranaviculare (OSSN) is generally low, symptomatic OSSN affects athletes. The aim of this study was to assess the variations of OSSN and the results of osteosynthesis between the OSSN and the navicular bone. Methods: Eleven feet of 10 elite athletes with symptomatic OSSN were treated. There were 3 male and 7 female patients with an average age of 19 years. Eight feet exhibited navicular stress fracture (NSF). Operative treatment was performed in 9 feet of 8 patients and 2 conservatively. Seven OSSNs were fixed with 1 or 2 screw(s) according to their size, using an autologous bone graft. The accompanying NSF was also treated surgically in 4 feet. Foot condition was evaluated using the Japanese Society for Surgery of the Foot (JSSF) midfoot rating scale and sports activity score of the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Results: The median OSSN was 12.7 mm in width, 5.6 mm in length, and 6.6 mm in height. The dorsal surface of the OSSN required at least 70 mm2 to be fixed using 2 screws. Seven OSSNs of 6 patients treated surgically successfully fused with the navicular. Two small OSSNs that were not stabilized with screws also fused after surgical treatment for NSF. However, one of the 2 OSSNs with NSF treated nonoperatively did not achieve fusion. The patients were followed up for 24-161 months. The median JSSF score improved from 87 to 97.7 postoperatively ( P = .00312). The median postoperative SAFE-Q sports score was 84.8. All patients returned to their original activities. Conclusion: Our results suggest that osteosynthesis with autologous bone graft was effective for symptomatic OSSNs. Even when the OSSN was small and not suitable for internal fixation, treatment of NSF was effective for union of OSSNs. The OSSN possibly belongs to a part or subtype of NSF. Level of Evidence: Level IV, retrospective case series.

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Section: Introductionmentioning

confidence: 98%