Navicular Fractures - Everything You Need To Know - Dr. Nabil Ebraheim

Описание: Educational video describing the condition of navicular fractures.
There are four types of navicular fractures:
1-Cortical avulsion Cortical avulsion fractures are due to excessive flexion or eversion of the midfoot, resulting in avulsion of the dorsal lip of the navicular by the talonavicular or naviculocuneiform ligaments.
Cortical avulsion fractures are the most common. They are treated with a boot or short leg cast.
2-Tuberosity fractures: tuberosity fractures are due to a forced eversion injury, resulting in avulsion of the tuberosity by the tibialis posterior tendon without joint surface disruption. Tuberosity fractures require ORIF if tibialis function is disrupted.
3-Body fractures: Sangeorzan classification of body fractures: divided into three radiographic types based on:
•The direction of the fracture line
•The direction of displacement of the forefoot and midfoot
•The pattern of joint disruption
Type I: the primary fracture line is transverse in the coronal plane with no angulation of the forefoot.
Type II: the primary fracture is dorsal-lateral to plantar-medial with dorsal and medial subluxation of the talonavicular joint ( and the major dorsomedial fragment) and adduction of the forefoot.
Type III: comminuted fracture of the body in the sagittal plane with lateral displacement of the forefoot and cuneonavicular joint disruption. Frequently associated with injuries to the cuboid or the anterior process of the calcaneus.
Treatment
•Body fractures result from high-energy trauma and intra-articular
•Associated with a high risk of post-traumatic arthritis
•Usually requires ORIF.
4-Stress fractures: The fracture line is sagittally oriented in the relatively avascular middle third in a proximal dorsal to distal plantar direction and may either be complete or incomplete.
Treatment : stress fractures are treated with short leg cast and non-weight bearing for six weeks and may need surgery.

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