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Navicular Fractures and the Importance of External Fixation

Navicular fractures are a common type of foot injury that can cause significant pain and mobility issues. These fractures occur in the navicular bone, which is located in the midfoot and plays a crucial role in supporting the arch of the foot. When a navicular fracture occurs, it is important to provide proper treatment to ensure proper healing and prevent long-term complications. One treatment option that has proven to be effective in many cases is external fixation. This article will explore the importance of external fixation in the treatment of navicular fractures, discussing its benefits, techniques, and outcomes.

The Navicular Bone: Structure and Function

Before delving into the importance of external fixation in treating navicular fractures, it is essential to understand the structure and function of the navicular bone. The navicular bone is one of the tarsal bones located in the midfoot region. It is shaped like a boat, hence its name, and is situated between the talus bone and the cuneiform bones.

The navicular bone plays a crucial role in maintaining the arch of the foot and providing stability during weight-bearing activities. It also serves as an attachment point for several ligaments and tendons, including the posterior tibial tendon, which is responsible for supporting the arch and controlling foot movement.

Navicular fractures can occur due to various causes, including trauma, repetitive stress, and underlying conditions such as osteoporosis. Athletes involved in high-impact sports, such as basketball or gymnastics, are particularly prone to navicular fractures.

The symptoms of a navicular fracture can vary depending on the severity of the injury. Common signs and symptoms include:

  • Pain and tenderness over the midfoot region
  • Swelling and bruising
  • Difficulty bearing weight on the affected foot
  • Decreased range of motion

If left untreated, navicular fractures can lead to long-term complications, such as chronic pain, arthritis, and deformities. Therefore, prompt and appropriate treatment is crucial to ensure optimal outcomes.

The Role of External Fixation in Navicular Fracture Treatment

External fixation is a treatment technique that involves the use of external devices, such as pins, wires, or frames, to stabilize fractured bones and promote proper healing. In the case of navicular fractures, external fixation can be a valuable treatment option, especially for complex or displaced fractures.

There are several reasons why external fixation is important in the treatment of navicular fractures:

  1. Stability: External fixation provides immediate stability to the fractured bone, reducing pain and preventing further displacement. This stability is crucial for proper healing and minimizing the risk of complications.
  2. Preservation of Blood Supply: Navicular fractures can disrupt the blood supply to the bone, leading to avascular necrosis (death of bone tissue). External fixation can help preserve the blood supply by reducing pressure on the fractured bone and promoting adequate circulation.
  3. Early Mobilization: External fixation allows for early mobilization of the foot, which is essential for maintaining joint range of motion and preventing stiffness. By providing stability and support, external fixation enables patients to start weight-bearing activities sooner, promoting a faster recovery.
  4. Reduced Risk of Infection: External fixation devices are placed outside the body, reducing the risk of infection compared to internal fixation methods, such as plates and screws. This is particularly important in the case of open fractures or when the skin integrity is compromised.
  5. Flexibility in Fracture Management: External fixation allows for precise control of fracture reduction and alignment. The devices can be adjusted or modified as needed during the healing process, ensuring optimal bone alignment and promoting successful fracture union.

Techniques and Outcomes of External Fixation in Navicular Fractures

There are different techniques and approaches to external fixation in the treatment of navicular fractures. The choice of technique depends on various factors, including the type and severity of the fracture, the patient’s age and activity level, and the surgeon’s preference and experience.

One commonly used technique is the Ilizarov method, which involves the use of circular external fixators. This method allows for precise control of bone alignment and provides excellent stability. Another technique is the use of percutaneous pins or screws, which can be inserted through small incisions to stabilize the fractured bone.

Studies have shown promising outcomes with the use of external fixation in navicular fracture treatment. A study published in the Journal of Orthopaedic Trauma found that external fixation resulted in a high rate of fracture union and good functional outcomes in a group of patients with displaced navicular fractures. Another study published in Foot & Ankle International reported successful outcomes with the use of circular external fixators in athletes with navicular stress fractures.

While external fixation can be an effective treatment option for navicular fractures, it is important to note that not all fractures require external fixation. Less severe fractures may be managed conservatively with immobilization, such as casting or bracing. The decision on the appropriate treatment approach should be made by a qualified orthopedic surgeon based on a thorough evaluation of the fracture characteristics and the patient’s individual circumstances.


Navicular fractures can be debilitating injuries that require prompt and appropriate treatment. External fixation has emerged as an important treatment option for navicular fractures, offering numerous benefits such as stability, preservation of blood supply, early mobilization, reduced risk of infection, and flexibility in fracture management. Various techniques, such as the Ilizarov method and percutaneous pinning, can be employed to achieve successful outcomes.

While external fixation has shown promising results, it is essential to consider individual factors and fracture characteristics when determining the most appropriate treatment approach. Consulting with a qualified orthopedic surgeon is crucial to ensure optimal outcomes and minimize the risk of complications.

In conclusion, external fixation plays a vital role in the treatment of navicular fractures, providing stability, promoting proper healing, and facilitating early mobilization. By understanding the importance of external fixation and its various techniques, healthcare professionals can effectively manage navicular fractures and improve patient outcomes.

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