A navicular stress fracture is a stress fracture of the navicular bone in the midfoot. It can occur in a running or jumping athlete, like a basketball player. It can be a serious injury. Physicians are usually very careful with this injury, often keeping the athlete from putting weight on it until the fracture heals, due to concerns that the fracture will not heal (nonunion). Many surgeons even advocate early surgical treatment, especially in high-level athletes. If the fracture does not heal, surgery to put bone graft in the fracture and hold it in place with one or two screws is indicated.

Signs and symptoms of a navicular stress fracture

An athlete struggling with a navicular stress fracture will often experience foot pain despite not having an initial injury to initiate the symptoms. The pain is often felt in the midfoot, along the top of the arch of the foot. Often the pain will come on after a certain amount of activity and will go away with rest. As it progresses, the pain comes earlier in the training session or game and takes longer to go away. Eventually the pain will not go away with rest and can affect activities of daily living, such as walking.

Illustration of the anatomy of the foot, including the navicular

Treatment options

A navicular stress fracture can be a challenging injury. Treatment usually does not require surgery. Still, orthopedic surgeons and sports medicine physicians are usually very careful with this injury. We usually place the athlete in a cast or boot and limit weightbearing due to the possibility of the fracture not healing. Some orthopedic surgeons argue for surgery, especially in high-level athletes. If the fracture does not heal, surgery to put bone graft in the fracture and hold it in place with one or two screws can be necessary.

A navicular stress fracture, regardless of whether it is treated surgically or non-surgically, often costs the athlete the majority, if not all, of the season. Usually the fracture has to be completely healed on x-ray before the surgeon will allow running and sports activities.

Also read:
Foot stress fracture: Which stress fractures are the most serious?
Signs your foot or ankle injury is serious

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