Navicular fracture

Background

Bones of the foot.
  • Navicular, cuboid, and cuneiform fractures are all diagnosed/managed in similar way

Clinical Features

  • Foot pain

Differential Diagnosis

Foot and Toe Fractures

Hindfoot

Midfoot

Forefoot

Evaluation

  • Imaging: (weight-bearing AP, lateral, oblique)
    • CT sometimes necessary

Management

General Fracture Management

  • Acute pain management
  • Open fractures require immediate IV antibiotics and urgent surgical washout
  • Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
  • Consider risk for compartment syndrome
  • If any limitation to range of motion, orthopedics will often perform elbow arthrocentesis to remove hemarthrosis which is often present
    • The purpose of this is to see whether range of motion is restored after aspiration since if it is not, this may be an indication for surgery
    • This is generally not necessary to perform in the ED but can be done for patient comfort

Immobilization

Disposition

  • Outpatient

See Also

References