Executive Editor: Joseph Schatzker

Authors: Richard Buckley, Andrew Sands

Midfoot - Navicular, split/stress

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Glossary

General considerations

This unusual fracture is usually a result of shortening of the medial column of the foot. It may be treated nonoperatively if its time course has been short, but may need open reduction if it is displaced or of long duration.

Nonoperative treatment
Main indication Skill Equipment
Undisplaced fracture or early appearance of presumed stress fracture. Basic surgical experience, no specialized skills Basic equipment only

Indications

  • Less than 2 mm displacement 
  • Acute painful stress fractures

Advantages

  • Nonoperative treatment
Screw fixation
Main indication Skill Equipment
Displaced fracture or long term stress fracture. Some specialized surgical experience Simple surgical and imaging resources

Indications

  • More than 2 mm displacement 
  • Chronic painful stress fractures

Advantages

  • Elimination of chronic pain of stress fracture
  • Accurate reconstruction of very important joint surface
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2010-10-14