mm wrote:
Mother nature made it possible that everything can heal itself - having screw in your foot just doesn't sound right.
'mother nature' didn't intend for us to wear boots and use crutches, either.
mm wrote:
Mother nature made it possible that everything can heal itself - having screw in your foot just doesn't sound right.
'mother nature' didn't intend for us to wear boots and use crutches, either.
just had a hurdler on my team have a pin put in his navicular stress fracture. This was after a May '06 season ending stress fracture, heal all summer, return to training in the fall everything going ok then popped up again in December after the 1st indoor meet. The bone stimulator has not been the most successful route with other guys in the past.
I just got off a navicular stress fracture. However, mine was different than yours, it was non-displaced and of a smaller magnitude. I was on crutches non-weightbearing for 10 weeks. I encourage you to look to the research; surgery is probably your best bet for a serious stress fracture of this bone. This injury has the highest likelihood of ending a distance runners career, do not treat it lightly!
The problem with an injury to the navicular bone is that it is similar to a fracture of the scaphoid bone in your wrist; it is notorious for healing slowly due to a lack of blood flow.
check out the research before you do anything. its the best way of determining what works best. opinions on the boards won't can't give you the same quality information that you can get from the research...
I had a trauma fx of my scaphoid (think navicular, but in your hand). Cast and bone stim for 10 weeks worked really well. I didn't get x-rays until 3 months following my fall. Both the navicular and scaphoid have notoriously poor blood supply, so bone stim is worth a shot...also you shouldn't have to BUY one, I just rented one from the physician.
But it depends on your goals. Long-term: boot and stim. Short-term (and you may pay for it the rest of your life with OA): surgery.
Any time you cut into a joint you increase the risk of long-term damage.
Get the damn surgery and try and make olympics. It will give you somthing to do besides wasting away on your website.
What do you feel are the advantages of back and front squats over various leg press/ squat machines that mimic the squatting motion?
Peter Gibbons, PT wrote:
Short-term (and you may pay for it the rest of your life with OA): surgery.
Any time you cut into a joint you increase the risk of long-term damage.
you must not really be a PT
the surgery doesn't involve cutting into a joint
you can't put a screw through the joint surface anyway
there is no reason to think that this surgery will cause OA.
Here is the key point:
Fifteen of 16 competitive athletes returned to full competition, including all who had ORIF.
It is possible to be treated both conservatively and surgically successfully. There is no correct answer to WEJO's dilemna. If conservative fails, then surgical should work.
ORIF stands for open reduction internal fixation, which means that every patient that had surgery in the study fully returned to their sport.
1: Foot Ankle Int. 2006 Nov;27(11):917-21. Links
Navicular stress fractures: a prospective study on athletes.Saxena A, Fullem B.
Palo Alto Medical Foundation, Department of Sports Medicine, PAMF 795 El Camino Real, Palo Alto, CA 94301, USA.
BACKGROUND: Navicular stress fractures of the foot often are difficult to diagnose and treat. METHODS: Nineteen athletic patients seen from 1999 to 2003, were compared to a previously treated group of 22 athletes with similar injuries treated from 1994 to 1998. Based on the frontal plane CT images, a previously described classification system was used to assess the injury: type I dorsal cortical break; type II fracture extending into the navicular body; and type III fracture breaches two cortices. Nonoperative treatment was recommended for patients with type I injuries and open reduction and internal fixation (ORIF) were recommended for those with type II and III injuries. The time to return to activity and ability to return to competition were assessed, along with differences between fracture type and gender. RESULTS: Return to activity (RTA) was 4.0 months for the entire group. RTA for type I (four injuries), type II (eight injuries), and type III (seven injuries) was 3.8, 3.7, and 4.2 months, respectively.Fifteen of 16 competitive athletes returned to full competition, including all who had ORIF.CONCLUSIONS: Navicular stress fractures can take 4 months to heal with nonoperative or operative treatment. Surgery should be considered for more severe injuries, which can be assessed by CT scan.
wejo,
The healing time for the surgery is not 5 months, it is 12 weeks. Then you can return to running. I pr'd 6 months after the surgery, so that is 3 months healing, then 3 months training. No problems at all since.
what's with all this mother nature stuff? ...a busted bone may heal itself but in Mother Nature's world, you'd be eaten by prey well beforehand so big whoop
can the screw come out after the injury has healed?
I'd go with whatever Doc Fullem recommends. Dude knows his stuff.
Spence
PS. He does not owe me any poker debts.
The screw can be removed at a later time if it becomes an issue (according to my orthopod).
for all of you who have had this, what were your symptoms and what do you think was the cause? i know someone who sprained an ankle playing soccer a month ago and is having pain in that region running ever since.
thanks!
A sprained ankle is damage to the ligaments. Stress fractures are broken (cracked) bones. Did your friend properly rest, ice, compress, and elevate the area right after the sprain? If not, that is probably why it is still bothering him/her.
He didn't rest as much as I thought he should! I also noticed that today that he has very pronounced navicular bones consistant with an accesory navicular and the sprain could have caused that to flare up. I am concerned that the sprain could have set him up for a sfrac. I am curious as to wether twisting injuries can lead to stres frac problems , even in the abscence of high mileage (40-50 a week).
marijuologist wrote:
you must not really be a PT
the surgery doesn't involve cutting into a joint
you can't put a screw through the joint surface anyway
there is no reason to think that this surgery will cause OA.
And I know you're not an orthopedic surgeon. But you are someone who is stupid enough to grow pot in his house.
I found this article:
http://www.aafp.org/afp/20030101/85.htmlrunamook wrote:
He didn't rest as much as I thought he should! I also noticed that today that he has very pronounced navicular bones consistant with an accesory navicular and the sprain could have caused that to flare up. I am concerned that the sprain could have set him up for a sfrac. I am curious as to wether twisting injuries can lead to stres frac problems , even in the abscence of high mileage (40-50 a week).
I twisted that ankle really bad like 3 times and didn't rehab it properly. I wonder if that somehow caused it. My outside ankle I think still is a little weak and I think I first twisted it 2 summers ago.
Wejo,
No boot and no surgery.
Your foot will heal with the blood flow going through it while walking and general daily life activities.
Just to state that my name is Conor McGee and I am not hiding behind some b.s. story or just spouting as many people do on this site. I had a stress fracture in my navicular tarsal during my sophomore year at Iona ('95-'96). I wore the boot and all healing stopped completely. I didn't run for 6 months, I built up unwanted upper body muscle from crutching everywhere for 13 weeks during which time no healing took place. Needless to say, I was very out of shape once I started back running. Muscles in my leg had atrophied so coming back was a long arduous process. The boot is a waste of time and it just makes your life difficult crutching everywhere. My comeback would have been far quicker if I had not worn that boot.
The doctor mentioned pins as well at one point once he saw the lack of healing apparent by the scans taken...but I was having no pin in my foot. I saw that as the end of my running at a high level. Only after I made the decision in conjunction with my coach, Mick Byrne, to throw the boot away did any healing take place. We had the common sense to know that something isn't right when your leg is going purple and no healing is taking place ... somehow my doctor didn't learn that in medical school.
So, go with your gut. These doctors don't know it all. Sometimes doctors get ahead of themselves. It doesn't make sense to go for the last resort first!
Pins and surgery are very radical. What age are you? I don't think you need a pin to keep your foot together. I mean, you're not suffering from any bone deficiencies are you? So, PLEASE just allow your body to heal over the course of 6-10 weeks and you will be fine. No boot required. And certainly no surgery. I wish someone had told me that when I had the injury.
I hope this advice helps and I hope you are listening mostly to people who have had experience of the injury.
PS> If you study physiology, you'll find that the navicular bone is pulled on by muscles in your calf. Muscles pull on bone. Regular sports massage and warm baths can prevent these muscles from getting too tight and pulling too hard on your bones -- this will go a long way toward preventing a recurrence of the injury.
Sincerely,
Conor McGee, Ireland.
The fracture looks very sclerotic and looks like it has "tried" to heal for quite some time. Here is my opinion for whatever it's worth:
1) If you are not concerned about "time" and are very adverse to surgery, than you have nothing to lose (except 8-12 weeks
non-weightbearing) by trying the bone stimulator and cast first. Surgery offers no guarantees, and there ARE additional risks involved (such as infection).
2) The best chance for success in the shortest amount of "down" time available would be to go ahead and have the fracture "cleaned out" - possibly with the addition of bone chips - to stimulate new bone growth and enhance healing. This should be supplemented by the bone stimulator and non-weightbearing 8-12 weeks post-op.
If these were radiographs from my foot, and I wished to run again, I would go under the knife tomorrow.