Navicular Fractures

  Initial Treatment
Splint type & position Lower extremity splint or bulky dressing
Stress fractures placed in cast at initial visit
Initial follow-up visit Within 7 days for definitive casting
Pt instructions Icing, compression, and elevation
Crutches as needed
  Follow-up Care
Cast or Splint type & position Dorsal avulsion: SLWC or compressive dressing
Tuberosity: SLWC
Body: below-knee walking cast
Stress: SLNWBC
Length of immobilization Dorsal avulsion: 4 to 6 weeks
Tuberosity: 4 to 6 weeks; additional 2 to 4 weeks if symptomatic nonunion at 6 weeks
Body: 6 to 8 weeks
Stress: 6 to 8 weeks
Healing time 6 to 10 weeks for complete clinical healing
Up to 6 months for complete return to activity after stress fracture
Follow-up visit interval Every 2 to 4 weeks
Repeat radiography interval At 6 weeks to document healing in tuberosity and body fracture
Every 2 to 4 weeks if nonunion is apparent at 6 weeks
Pt instruction Ankle and foot ROM exercises
Calf muscle stretching and strengthening
Indications for Ortho consult Large displaced dorsal avulsion fractures
Tuberosity fractures with >1 cm proximal displacement
Displaced body fractures
Nonunion or delayed union stress fracture
Persistent symptoms after treatment of avulsion or tuberosity fractures
ROM, range of motion; SLNWBC, short-leg non–weight bearing cast; SLWC, short-leg walking cast.

Return to Work or Sports