The Outcomes of Navicular Fracture Surgery

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00098892%3A_____%2F25%3A10159233" target="_blank" >RIV/00098892:_____/25:10159233 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/25:43928296 RIV/00216208:11320/25:10496651 RIV/61989592:15110/25:73635990

Result on the web

<a href="https://achot.cz/artkey/ach-202501-0004_the-outcomes-of-navicular-fracture-surgery.php" target="_blank" >https://achot.cz/artkey/ach-202501-0004_the-outcomes-of-navicular-fracture-surgery.php</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.55095/achot2024/034" target="_blank" >10.55095/achot2024/034</a>

Result language

angličtina

Original language name

The Outcomes of Navicular Fracture Surgery

Original language description

Purpose of study: Inadequate treatment of displaced fractures of the navicular bone may result in malalignment, formation of non-union, accelerated development of osteoarthritis or avascular necrosis and thus a fundamental limitation of mobility and gait disturbance. The aim of our study was to evaluate the results in our group of patients undergoing surgery for navicular fractures. Material and methods: Our retrospective monocentric study included all surgically treated navicular fractures in patients over 18 years of age performed in our department between 2009 and 2018. A total of 18 patients met these criteria and were invited for clinical and radiographic follow-up. One patient refused to attend and two were lost to follow-up. The remaining 15 patients underwent clinical assessment, including the use of AOFAS midfoot and VAS scores, and the grade of osteoarthritis was determined using radiographs. Results: Our final group of patients consisted of six women and nine men. The mean age of the patients at the time of surgery was 43 (21–67) years, with mean follow-up duration of 68 (18–130) months. The most common mechanism of trauma was high-energy injury occurring in nine of cases. According to the Schmid classification, six fractures were Type I and II each whereas three cases were Type III fractures. Concomitant injuries involving the foot and ankle were present in six cases. All fractures healed. Open reduction and internal fixation (ORIF) was performed in 14 cases. The radiographs showed the presence of osteoarthritis grade 0 or I in nine patients and osteoarthritis grades II and III in six patients. The AOFAS Midfoot scale was excellent and good in eleven cases, satisfactory in two and poor also in two cases. The average AOFAS Midfoot scale was 87.7 points. A procedure-related complication was a case of skin necrosis in a patient eventually undergoing cuneonaviculotalar arthrodesis in another hospital. Discussion: Consistent with literature data, our group showed a higher incidence of concomitant injuries in the foot region. Use of two approaches was not associated with an increased risk of developing avascular necrosis. We do not recommend the use of Kirschner wires for definitive osteosynthesis although we do use them as part of staged treatment or as an additional type of fixation. Like other authors, we observed higher grades of post-traumatic osteoarthritis in the subgroup of patients with more severe injuries. Conclusion: Open reduction and stable osteosynthesis of navicular fracture-displacements are associated with good outcomes in most patients. The most serious consequences of these fractures are post-traumatic arthritis and pain. It is critical to search for concomitant injuries. Given the rarity of these fractures, they should be preferably treated in specialised medical centres.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30212 - Surgery

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca

ISSN

0001-5415

e-ISSN

2570-981X

Volume of the periodical

92

Issue of the periodical within the volume

1

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

8

Pages from-to

28-35

UT code for WoS article

001460145600004

EID of the result in the Scopus database

2-s2.0-105000546931