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Navicular Body Fractures



- Discussion:
    - frx of body of navicular may be associated w/ mid-tarsal joint injuries;
    - classification: 3 types:
         - coronal plane fracture w/ no angulation of the forefoot;
                - displaced frx require ORIF w/ lag screw fixation;
                - through dorsomedial longitudinal incision, frx can be visualized;
         - frx line is dorsolateral to plantar medial
                - forefoot is displaced medially;
                - reduction is difficult to maintain, because there is frequent comminution of the plantar lateral fragment;
         - fracture is comminuted & forefoot is displaced laterally;
                - results are usually poor;

- Radiographs:
    - frequently navicular body frxs are only seen on lateral projection;

- Non Operative Treatment:
    - if these fractures are truly non displaced, they are treated w/ a below knee walking cast for 6 weeks;

- Operative Treatment:
    - if frx is even minimally displaced, closed treatment is of little value because even if reduction can be achieved,
           recurrent displacement of fragments usually occurs;
    - late arthritis is common



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