ESPNBoston.com is reporting that Boston Red Sox star Dustin Pedroia underwent surgery Friday to fix a fractured navicular bone in his foot. The fracture reportedly occurred on June 25, when Pedroia fouled a pitch off his foot. I don’t know exactly the course of events over the two months or so since the injury occurred, but it sounds like the Red Sox doctors tried to get the fracture to heal with nonoperative means. The star second baseman was likely kept completely nonweightbearing while awaiting the fracture to heal. He was activated from the disabled list on August 17, after approximately 2 months out of the Red Sox lineup. He reportedly played two games before returning to the disabled list. ESPNBoston.com also reported previously that the Red Sox doctors had Pedroia seek a second opinion with Dr. Robert Anderson, a foot and ankle specialist. Yesterday Pedroia had surgery that reportedly involved putting a screw across the bone to try to promote healing.
A navicular fracture is a very difficult injury in athletes. Very frequently, it is the location of a stress fracture, where the bone is injured with repetitive stress over time. This is a common injury in running athletes and military personnel. In this case, it sounds like Pedroia suffered a traumatic injury to the navicular. Regardless of traumatic versus overuse injury to the navicular, it is a very difficult fracture to get to heal properly. The navicular has a less than optimal blood supply for healing, and there is great stress across this bone. The combination of those factors makes nonunion in athletes more likely than sports medicine physicians would like. Some surgeons will even try surgery right after the injury occurs to prevent the possibility of nonunion. Having said that, it sounds like the Red Sox doctors tried an appropriate course of nonoperative treatment, because I feel that if you can get an athlete to heal an injury without surgery, that’s always a good option. If a nonunion does occur with nonoperative treatment, surgery can involve putting bone graft in the fracture site and then fixing it with one or two screws.
Read more about treatment of navicular stress fractures.