From the Department of Orthopaedic Surgery, Mayo Clinic Arizona, Phoenix, AZ (Patel, Christopher), and Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Drakos, O'Malley).
J Am Acad Orthop Surg. 2021 Feb 15;29(4):148-157. doi: 10.5435/JAAOS-D-20-00869.
Navicular stress fractures are multifactorial injuries due to chronic overload on the navicular, particularly in young athletes. The navicular is subject to unique stresses and has a complex blood supply, making it susceptible to stress fractures and potentially delayed union or nonunion. Expeditious diagnosis is critical to prevent a delay in treatment and a poor outcome. Advanced imaging is essential in making the diagnosis and monitoring healing. Both nonsurgical and surgical treatments have demonstrated good results. Nonsurgical management consists of a period of immobilization and nonweight bearing, and surgical management typically involves open reduction and internal fixation. Patients need to be appropriately counseled regarding expectations for these challenging injuries.
舟骨应力性骨折是由于舟骨长期受到慢性超负荷作用引起的多因素损伤,尤其是在年轻运动员中。舟骨承受着独特的应力,并有复杂的血液供应,使其易发生应力性骨折,并可能导致延迟愈合或不愈合。快速诊断对于防止治疗延误和不良后果至关重要。高级影像学检查对于诊断和监测愈合至关重要。非手术和手术治疗均已显示出良好的效果。非手术治疗包括固定和不负重一段时间,而手术治疗通常包括切开复位和内固定。需要向患者提供有关这些具有挑战性损伤的预期的适当咨询。