Johnston Thomas R, McCormick William Fray, Donley Connor J, McCrosson Matthew, Schick Samuel, Johnson Michael D
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.
OTA Int. 2025 May 7;8(2):e397. doi: 10.1097/OI9.0000000000000397. eCollection 2025 Jun.
To examine fracture patterns and surgical data to assess radiographic outcomes and complications after open reduction and internal fixation of navicular fractures.
Retrospective cohort study.
A single level 1 trauma center.
Patients who underwent operative treatment of a navicular fracture. Patients exclusion criteria included nonoperative management, less than 6 months of follow-up, patients younger than 18 years, or if they underwent a fusion at index operation.
Operative treatment of the navicular.
Clinical and radiographic postoperative complications and patient-reported outcomes.
Thirty-eight patients met inclusion criteria. Seven patients had at least 1 postoperative complication. Radiographically, there were 7 cases of talonavicular joint (TNJ) arthritis, 6 cases of navicular avascular necrosis (AVN), and 7 cases of foot collapse. Navicular fractures with TNJ dislocation are associated with an increased rate of progression to TNJ arthritis ( = 0.009) while those requiring TNJ spanning fixation are associated with increased rates of navicular AVN ( = 0.047) and reoperation ( = 0.007). The mean PROMIS Physical Function (PF) score was 46.48 (9.99) ( = 0.088) and Pain Interference (PI) score was 56.79 (8.10) ( = 0.002) after a minimum of 2 years of follow-up. The PROMIS PF score was 46.48 (9.99) ( = 0.088) and PI score was 56.79 (8.10) ( = 0.002) after a minimum of 2 years of follow-up.
Patients with a TNJ dislocation have increased rates of TNJ arthritis while TNJ spanning fixation is associated with increased rates of navicular AVN and reoperation.
Level IV.
研究骨折类型及手术数据，以评估舟骨骨折切开复位内固定术后的影像学结果及并发症。
回顾性队列研究。
单一的一级创伤中心。
接受舟骨骨折手术治疗的患者。患者排除标准包括非手术治疗、随访时间少于6个月、年龄小于18岁，或在初次手术时接受了融合手术。
舟骨的手术治疗。
临床和影像学术后并发症以及患者报告的结局。
38例患者符合纳入标准。7例患者至少有1种术后并发症。影像学检查显示，有7例距舟关节（TNJ）关节炎、6例舟骨缺血性坏死（AVN）和7例足部塌陷。TNJ脱位的舟骨骨折发展为TNJ关节炎的发生率增加（P = 0.009），而需要TNJ跨越固定的骨折发生舟骨AVN和再次手术的发生率增加（P分别为0.047和0.007）。至少随访2年后，患者报告结局测量信息系统（PROMIS）身体功能（PF）平均评分为46.48（9.99）（P = 0.088），疼痛干扰（PI）评分为56.79（8.10）（P = 0.002）。至少随访2年后，PROMIS PF评分为46.48（9.99）（P = 0.088），PI评分为56.79（8.10）（P = 0.002）。
TNJ脱位患者发生TNJ关节炎的发生率增加，而TNJ跨越固定与舟骨AVN和再次手术的发生率增加有关。
四级。
