Investigation and Treatment of Foot Bone Fracture:

A navicular fracture is a crack of the navicular cuboid of the feet, a cuboid on the top of the mid-foot. This is the keystone of the medial longitudinal arch of the foot.

Mechanism of Injury

• Direct blow: Rare, can cause avulsion or crush injuries.
• Indirect forces: Due to fall from height, sports-related injuries or due to RTA.

OTA Classification

• Group A:  Extra-articular fracture.
• Group B: Involvement of the talonavicular joint.
• Group C: Involvement of both talonavicular and talocuneiform joints.

Each group is further subclassified depending upon fracture types and position.

Clinical Features

• The patient complains of pain, swelling, and limp.
• Tenderness can be elicited over the navicular bone.

Investigations

AP and lateral X-rays of the joint and CT scan give more reliable information about the fracture pattern.

Treatment

• Nonoperative treatment: This is indicated in undisplaced fractures and in fracture with less than 2 mm displacement of the talonavicular joint. The treatment consists of short leg NWB cast for 6-8 weeks.
• Operative treatment: This is reserved for displaced fractures with > 2 mm separation. Fixation can be achieved most of the times by screw fixation alone. If more than 40 percent of the articular surface is damaged, talonavicular fusion should be considered.

Complications

• Nonunion
• Avascular necrosis
• Collapse of the arch
• Post-traumatic osteoarthritis

At Accessible Physical Therapy Services we provide a full range of therapy services including but not limited to ultrasound electric stimulation, traction, therapeutic exercises, massage and aquatic therapy. Call now at: (301) 593-7300

http://www.accessiblept.com