What's the diagnosis? By Dr. Erica Schramm
A 60 year old female presents with right foot pain following a trip and fall. She reports everting her ankle. She is unable to bear weight. She has swelling and tenderness of her medial forefoot. An x-ray is shown below. What's the diagnosis? Scroll down for answer.
Answer: Nondisplaced fracture of the right navicular bone
- Most common mechanism: Eversion injury (stress exerted on the deltoid and talonavicular ligaments); Stress fractures can also occur in athletes with repetitive jumping and sprinting.
- Physical exam findings: Local pain and swelling, medial arch pain
- Treatment: Immobilization (posterior short leg splint) and non-weight bearing are first line for 6-8 weeks; Surgical repair is usually reserved only for severely displaced fractures or failure of immobilization.
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W. Scott, et al.. "Common Upper & Lower Extremity Fractures." CURRENT Diagnosis & Treatment: Family Medicine, 4e Eds. Jeannette E. South-Paul, et al. New York, NY: McGraw-Hill, 2018.