Navicular stress fractures: Outcomes of surgical and conservative management

Potter, N. J., Brukner, P. D., Makdissi, M., Crossley, K. and Kiss, Z. S. (2006). Navicular stress fractures: Outcomes of surgical and conservative management. In: British Journal of Sports Medicine. 2004 Australian Conference of Science and Medicine in Sport Hot topics from the Red Centre, Alice Springs, NT, Australia, (692-695). 06-09 October 2004. doi:10.1136/bjsm.2005.022079


Author Potter, N. J.
Brukner, P. D.
Makdissi, M.
Crossley, K.
Kiss, Z. S.
Title of paper Navicular stress fractures: Outcomes of surgical and conservative management
Conference name 2004 Australian Conference of Science and Medicine in Sport Hot topics from the Red Centre
Conference location Alice Springs, NT, Australia
Conference dates 06-09 October 2004
Proceedings title British Journal of Sports Medicine   Check publisher's open access policy
Journal name British Journal of Sports Medicine   Check publisher's open access policy
Place of Publication London
Publisher BMJ Publishing Group
Publication Year 2006
Sub-type Fully published paper
DOI 10.1136/bjsm.2005.022079
Open Access Status Not Open Access
ISSN 0306-3674
1473-0480
Volume 40
Issue 8
Start page 692
End page 695
Total pages 4
Language eng
Formatted Abstract/Summary
Objective:
To compare the long term outcomes of the two treatment options for navicular stress fractures: non-weightbearing cast immobilisation and surgical fixation.

Design:

Retrospective case study.

Participants:
Subjects aged 18 years and older who had been treated for a navicular stress fracture more than two years previously.

Main outcome measures:
Questionnaire based analogue pain score and function score; tenderness on palpation; abnormality detected on computed tomography (CT).

Results:
In all, 32 fractures in 26 subjects were investigated. No significant differences were found between surgical and conservative management for current pain (p = 0.984), current function (p = 0.170), or abnormality on CT (p = 0.173). However, surgically treated patients more often remained tender over the "N spot" (p = 0.005), even after returning to competition for two years or more.

Conclusions:
Surgical fixation of navicular stress fractures appears to be as effective as conservative management over the longer term. However, there remains a small but measurable degree of pain and loss of function over this period. The value of using "N spot" tenderness as the sole clinical predictor of treatment success requires further investigation, as some patients remained tender despite successful completion of treatment and return to competition.
Subjects 110604 Sports Medicine
1106 Human Movement and Sports Science
Keyword Sports medicine
Sports
Sports injuries
Stress fracture
Navicular
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published as "Original Article"

 
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Created: Mon, 06 Apr 2009, 22:19:03 EST by Ms Karen Naughton on behalf of School of Human Movement and Nutrition Sciences