Tarsal Navicular Fracture

Concurrent Fracture dislocation (high energy injury)
1. Talocalcaneonavicular joint
2. Calcaneocuboid joint
3. Naviculocuneiform joint
Avulsion Fracture (50% of Navicular Fractures)
1. Plantar flexion with inversion or eversion
Tuberosity Fracture
1. Eversion injury
Navicular body Fracture
1. Direct or axial load
Stress Fracture
1. Tarsal Navicular Stress Fracture

Weight-Bearing, Three View Foot XRay (AP, lateral, oblique)
1. Obtain initial and again every 2 weeks until healed
  1. Monitor for nonunion
2. Findings
  1. Avulsion Fracture
  2. Tuberosity Fracture
  3. Tarsal Navicular body Fracture
Advanced imaging indications
1. Tarsal Navicular Stress Fracture
2. May be indicated per specialist recommendation to define Fracture lines and associated Soft Tissue Injury

See Tarsal Navicular Stress Fracture
Minor avulsion Fracture (low energy injury)
1. Short Leg Walking Cast or boot for 4 to 6 weeks
2. May switch to hard soled shoe at 4 weeks if healing on XRay and exam
Navicular body Fracture
1. Short Leg Walking Cast or boot for 6 to 8 weeks
Significant injury with suspected Ligamentous Injury
1. Non-weight bearing and splint
2. Orthopedic or Podiatry referral
Orthopedic or Podiatry Referral Indications
1. Orthopedic referral in most cases
  1. Surgery often required (outside minor avulsion Fractures)
2. Dorsal Avulsion Fracture affecting >20% of talonavicular joint
3. Tuberosity avulsion Fracture with >1 cm displacement
4. Navicular body Fracture
  1. Displacement >1 mm
  2. Shortening >2 mm
  3. Fracture non-union at 6 to 10 weeks