--- title: "Navicular stress fracture outcomes in athletes. | Sutter Health" description: "Study evaluated factors that might be significant and affect healing navicular stress fracture outcomes, specifically focusing on the return to activity time." url: "https://www.sutterhealth.org/research/publications/navicular-stress-fracture-outcomes-in-athletes-1055312351" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Navicular stress fracture outcomes in athletes. # Navicular stress fracture outcomes in athletes: analysis of 62 injuries. Saxena A, Behan SA, Valerio DL, & Frosch DL. _J Foot Ankle Surg. 56(5):943-948. doi: 10.1053/j.jfas.2017.06.009._ 2017-09-01 ## Abstract The optimal treatment modalities for navicular stress fractures in athletes is currently unknown for this season-ending injury. The present study evaluated factors that might be significant and affect healing outcomes, specifically focusing on the return to activity (RTA) time and a decreased desired activity (DDA) after treatment in athletes. Such considerations included previous navicular stress fractures, patient demographic data and type of sport, and initiation time of treatment. The data from 59 patients with 62 fractures were prospectively analyzed from May 2005 through July 2016. The results showed a significant correlation between a previous navicular stress fracture and decreased desired activity. The average duration of symptoms before receiving definitive treatment was 8.8 months. Computed tomography as the initial imaging modality correlated positively with a correct diagnosis (1.00). In contrast, magnetic resonance imaging, when used initially, was only 71% accurate. Runners constituted most of the cohort at 38 (61.3%). Ten other athletes were involved in jumping sports. Of the 62 injuries, 21 (33.9%) were in elite or professional athletes, all of whom were able to RTA, with 1 patient, a 38-year-old world record holding runner, having a DDA. Seven refractures (11.2%) occurred an average >5 years after the initial injury, predominantly in those aged <21 years, none with previous surgery. Eight patients (12.9%) developed postinjury arthrosis, including 1 with DDA. Patients who underwent open reduction and internal fixation had a RTA of 4.56 months compared with those who had undergone nonoperative treatment, who had an average RTA of 3.97 months. Seven patients (11.2%) underwent screw removal and required a longer RTA. Overall, of the 62 injuries, the patients with 57 of the injuries (91.9%) were able to RTA at their preinjury level. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/28842101) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Radial soundwave for sesamoidopathy in athletes: a pilot study.](https://www.sutterhealth.org/research/publications/radial-soundwave-sesamoidopathy-athletes-1055312521) Saxena A, Yun A, Patel R, Gerdesmeyer L, Maffulli N. J Foot Ankle Surg. pii: S1067-2516(16)30186-7. doi: 10.1053/j.jfas.2016.07.024. \[Epub ahead of print\] Send to 2016 Sep 08 - Publication ### [Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete.](https://www.sutterhealth.org/research/publications/heel-pain-shockwave-tx-endosc-fasciotomy-1055312338) Saxena A, Fournier M, Gerdesmeyer L, Gollwitzer H. Muscles Ligaments Tendons J. 2(4):312-6. Print 2012 Oct. 2013 Jan 21 - Publication ### [Association of short-term complications with procedures through separate incisions during total ankle replacement.](https://www.sutterhealth.org/research/publications/short-term-complications-sep-incisions-tar-1055312445) Criswell B, Hunt K, Kim T, Chou L, Haskell A. Foot Ankle Int. pii: 1071100716651964. \[Epub ahead of print\] 2016 Jun 08 - Publication ### [Fixation of osteoporotic distal fibula fractures: A biomechanical comparison of locking versus conventional plates.](https://www.sutterhealth.org/research/publications/fixation-osteoporotic-distal-fibula-fx-1055312983) Kim T, Ayturk UM, Haskell A, Miclau T, Puttlitz CM. J Foot Ankle Surg. 46(1):2-6. 2007 Jan 01 - Publication ### [Magnetic resonance imaging and incidental findings of lateral ankle pathologic features with asymptomatic ankles.](https://www.sutterhealth.org/research/publications/mri-lateral-ankle-pathology-no-symptoms-1055312431) Saxena A, Luhadiya A, Ewen B, Goumas C. J Foot Ankle Surg. 50(4):413-5. doi: 10.1053/j.jfas.2011.03.011. Epub 2011 May 12. 2011 Jul 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/navicular-stress-fracture-outcomes-in-athletes-1055312351#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Navicular stress fracture outcomes in athletes."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/navicular-stress-fracture-outcomes-in-athletes-1055312351#medicalscholarlyarticle","name":"Navicular stress fracture outcomes in athletes: analysis of 62 injuries.","headline":"Navicular stress fracture outcomes in athletes.","abstract":"The optimal treatment modalities for navicular stress fractures in athletes is currently unknown for this season-ending injury. The present study evaluated factors that might be significant and affect healing outcomes, specifically focusing on the return to activity (RTA) time and a decreased desired activity (DDA) after treatment in athletes. Such considerations included previous navicular stress fractures, patient demographic data and type of sport, and initiation time of treatment. The data from 59 patients with 62 fractures were prospectively analyzed from May 2005 through July 2016. The results showed a significant correlation between a previous navicular stress fracture and decreased desired activity. The average duration of symptoms before receiving definitive treatment was 8.8 months. Computed tomography as the initial imaging modality correlated positively with a correct diagnosis (1.00). In contrast, magnetic resonance imaging, when used initially, was only 71% accurate. Runners constituted most of the cohort at 38 (61.3%). Ten other athletes were involved in jumping sports. Of the 62 injuries, 21 (33.9%) were in elite or professional athletes, all of whom were able to RTA, with 1 patient, a 38-year-old world record holding runner, having a DDA. Seven refractures (11.2%) occurred an average >5 years after the initial injury, predominantly in those aged \u003c21 years, none with previous surgery. Eight patients (12.9%) developed postinjury arthrosis, including 1 with DDA. Patients who underwent open reduction and internal fixation had a RTA of 4.56 months compared with those who had undergone nonoperative treatment, who had an average RTA of 3.97 months. Seven patients (11.2%) underwent screw removal and required a longer RTA. 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