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Navicular Stress Fracture - 9 mths old
I need advice. I started having mid foot pain 9 months ago. Unfortunately it took 6 months to identify a Navicular Stress Fracture. MRI findings are listed below:
Abnormal longitudinal vertical cleft with corticated margins involves the mid navicular bone waist with only a small component of bridging bone and marrow posteriorly and inferiorly. A previous partial fracture with an ununited component is likely. In fact, an up to 7-mm fibrocystic change along this cleavage plane dorsally is present as well is abnormal marrow edema evident by increased signal on T2 weighted images and lower signal on T1 weighted images in the adjacent medial and lateral aspects of the navicular along the cleavage plane.
I've been in a walking boot for the last 3 months. I started using a bone stimulator a month ago. We are seeing a tiny bit of healing progress each month by Xray. My doctor basically told me it was up to me, we could continue the boot for another 4 weeks since it is healing OR we could jump to fixation surgery with a bone graft. Last month the fracture went almost 2/3 of the way through the bone. This month it is a little over the 1/2 way point. She recommended 4 more weeks in the boot, but would fully support a decision of doing surgery..
I decided to go another 4 weeks in the boot. The doctor said I could call and change my mind at any time and she would set up surgery.
I'm not questioning if I made the right choice and any advice is welcomed.
Thank you,
Abnormal longitudinal vertical cleft with corticated margins involves the mid navicular bone waist with only a small component of bridging bone and marrow posteriorly and inferiorly. A previous partial fracture with an ununited component is likely. In fact, an up to 7-mm fibrocystic change along this cleavage plane dorsally is present as well is abnormal marrow edema evident by increased signal on T2 weighted images and lower signal on T1 weighted images in the adjacent medial and lateral aspects of the navicular along the cleavage plane.
I've been in a walking boot for the last 3 months. I started using a bone stimulator a month ago. We are seeing a tiny bit of healing progress each month by Xray. My doctor basically told me it was up to me, we could continue the boot for another 4 weeks since it is healing OR we could jump to fixation surgery with a bone graft. Last month the fracture went almost 2/3 of the way through the bone. This month it is a little over the 1/2 way point. She recommended 4 more weeks in the boot, but would fully support a decision of doing surgery..
I decided to go another 4 weeks in the boot. The doctor said I could call and change my mind at any time and she would set up surgery.
I'm not questioning if I made the right choice and any advice is welcomed.
Thank you,
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With definite evidence of healing, I would support the choice made. With the progress described, the fracture is expected to heal on its own given some time and surgery may have been unnecessary. I would suggest giving it a few more weeks and if there is no further improvement, the decision for a surgery can be taken at a later date as well.
Hope this is helpful.
Take care!