Rosenbaum Andrew J, Uhl Richard L, DiPreta John A
Orthopedics. 2014 Aug;37(8):541-6. doi: 10.3928/01477447-20140728-07.
The tarsal navicular plays an integral role in hind-foot motion and gait, and is the keystone of the foot's medial longitudinal arch. As such, injuries to the navicular can be devastating. Acute avulsion, tuberosity, and body fractures have been described. Fractures of the body result from high-energy trauma and are often seen in conjunction with additional ipsilateral foot injuries. Plain radiographs are the gold standard for diagnosis, with computed tomography helpful in the presence of intra-articular fracture extension. Non-operative treatment is reserved for avulsion injuries and non-displaced body fractures. Open reduction and internal fixation must be performed for all other types, as failure to achieve an anatomic reduction can impede proper locomotion. Complications following operative intervention include pain, stiffness, posttraumatic arthritis, avascular necrosis, nonunion, and hindfoot deformity.
距舟骨在足后段运动和步态中起着不可或缺的作用，是足部内侧纵弓的关键结构。因此，舟骨损伤可能是灾难性的。急性撕脱伤、结节骨折和体部骨折均有相关报道。体部骨折由高能创伤导致，常伴有同侧足部其他损伤。X线平片是诊断的金标准，计算机断层扫描有助于诊断关节内骨折延伸情况。非手术治疗适用于撕脱伤和无移位的体部骨折。其他所有类型骨折均须进行切开复位内固定，因为未能实现解剖复位会妨碍正常运动。手术干预后的并发症包括疼痛、僵硬、创伤后关节炎、缺血性坏死、骨不连和后足畸形。
