Stress fracture of the navicular bone: Nine cases in athletes

Hulkko, A; Orava, Sakari; Peltokallio, P; Tulikoura, I; Walden, Markku

doi:10.3109/17453678508993045

Cited by 48 publications

(19 citation statements)

References 5 publications

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“…Other stress fractures with an inherent tendency for delayed healing are those of the olecranon, the sesamoid bones, and the anterior midtibia (19,20,46). Clear indications for surgical therapy are dislocations and nonunions, and surgery is also indicated in some cases of delayed union when the interruption in training threatens to become disproportionately long (10,19,20,21,22,61,62). The highly motivated athletes engaged at the international level seem to experience the greatest risk of multiple separate fractures, protracted healing, or fractures requiring surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Prevention of stress fractures has proved to be problematic even under the well-controlied army conditions (51), although some progress has been made (55). Also, it has been shown in several recent reports that many stress fractures tend to exhibit delayed union or nonunion, requiring either a very long period of rest or surgical therapy before healing takes place (10,19,20,21,22,46,61,62).…”

Section: Introductionmentioning

confidence: 99%

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Stress Fractures in Athletes

Hulkko¹,

Orava²

1987

Int J Sports Med

246

114

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During the 14-year period of 1971-1985, 368 stress fractures in 324 athletes were treated. The series contained 268 fractures in males and 100 fractures in females; 32 fractures occurred in children (less than 16 years), 117 in adolescents (16-19 years), and 219 in adults. Forty-six fractures were incurred by athletes at an international level, 274 by athletes at a national or district level and 48 by recreational athletes. Of the total cases, 72% occurred to runners and a further 12% to athletes in other sports after running exercises. The distribution of the stress fractures by site was: tibia 182, metatarsal bones 73, fibula 44, big toe sesamoid bones 15, femoral shaft 14, femoral neck 9, tarsal navicular 9, pelvis 7, olecranon 5 and other bones 10. Of the total fractures, 342 were treated conservatively and 26 fractures required surgical treatment. The operative indication was dislocation in 5 cases and delayed union/nonunion in 21 cases. The sites most often affected by delayed union were: anterior midtibia, sesamoid bones of the big toe, base of the fifth metatarsal, olecranon, and tarsal navicular. The athletes at an international level experienced the greatest risk of multiple separate fractures, protracted healing, or fractures requiring surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stress Fractures in Athletes

Hulkko¹,

Orava²

1987

Int J Sports Med

246

114

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“…Stress fractures of the navicular bone reportedly account for only 0.7-2.4% of all cases of stress fractures [1][2][3][4]. However, the recent developments in imaging techniques have enabled the detection of a greater number of cases of stress fractures of the navicular bone-a recent report stated the incidence of such fractures is 15% [5].…”

Section: Discussionmentioning

confidence: 99%

“…Stress fractures of the navicular bone are rare, and account for 0.7-2.4% of all stress fractures [1][2][3][4]. Although stress fractures of the navicular bone are often observed in individuals aged 10-29 years who frequently engage in athletic activities, such fractures have not been reported in cases with cerebral palsy (CP).…”

Section: Introductionmentioning

confidence: 99%

Stress Fracture of the Navicular Bone in a Patient with Cerebral Palsy: A Case Report

Yoshikawa

Nakanishi

Kawamura

et al. 2015

J UOEH

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A 14-year-old girl with cerebral palsy (spastic diplegia) underwent examination due to a chief complaint of right foot pain, and was diagnosed with a stress fracture of the central one third of the navicular bone. The fracture was considered to have developed due to repeated loading on the navicular bone as a result of an equinus gait.Therefore, she underwent osteosynthesis and Achilles tendon lengthening to correct the equinus deformity. Following our review of the current literature, we did not identify any reports of stress fracture of the navicular bone in cerebral palsy. We believe that in cases where cerebral palsy patients with paralytic equinus complain of foot pain, the possibility of stress fracture of the navicular bone should be considered.

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“…4. Radioisotope scan is not useful for monitoring fracture healing because the scan remains positive long after clinical union.11 5. Repeat CT scans 3 months from the commencement of nonweightbearing cast immobilization usually show blurring of the fracture line and cortical bridging.…”

Section: Interpretation Of Initial Ct Scansmentioning

confidence: 97%

Outcome of conservative and surgical management of navicular stress fracture in athletes

et al. 1992

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Eighty-two athletes with 86 clinical navicular stress fractures, all imaged with computerized tomography, were followed for an average of 33 months (range, 6 to 108) after diagnosis. Initial treatment consisted of at least 6 weeks of nonweightbearing cast immobilization for 22 fractures, at least 6 weeks of limitation of activity with continued weightbearing for 34 fractures, and a period of less than 6 weeks of conservative treatment for another 19 fractures. Five patients attempted to continue playing sports. Six patients had immediate surgery. Nineteen of 22 patients (86%) who had initial non-weightbearing cast immobilization treatment returned to sports, compared with only 9 of 34 patients (26%) who initially continued weightbearing with limited activity (P < 0.001). After failure of the latter treatment, successful outcomes were seen for 6 of 7 patients (86%) treated with nonweightbearing cast immobilization, while 11 of 15 patients (73%) who had one surgical procedure were able to return to sports. These results indicate that nonweightbearing cast immobilization is the treatment of choice for navicular stress fractures. Also, this treatment compares favorably with surgical treatment for patients who present after failed weightbearing treatments. Computerized tomographic appearances of healing fractures do not necessarily mirror clinical union, and postimmobilization management should be monitored clinically.

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Stress fracture of the navicular bone: Nine cases in athletes

Cited by 48 publications

References 5 publications

Stress Fractures in Athletes

Stress Fractures in Athletes

Stress Fracture of the Navicular Bone in a Patient with Cerebral Palsy: A Case Report

Outcome of conservative and surgical management of navicular stress fracture in athletes

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