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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Common Is Removal Of Navicular Chip Fracture Fragments?

I twisted my left ankle 16 days ago. On lateral radiographs I have an 8mm long chip fracture of the proximal/dorsal aspect of my navicular bone (fracture line enters the talonavicular joint) that is rotated 90 degrees proximally. The orthopedic surgeon wants to remove it to "prevent arthritis" but all the references I can find online recommend conservative management. I have been staying off of the foot for the past two weeks but the NP put me into a walking air cast boot yesterday and recommended partial weightbearing. My foot is not painful when nonweightbearing but I do feel tingling on the bottom of my foot when I bear a small amount of weight. I also have a lateral collateral ligament sprain. My foot swelling is mild to moderate.

1) Is removal of navicular chip fracture fragments common/indicated?
2) Is walking or immobilization better?
Fri, 29 Dec 2017
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Orthopaedic Surgeon 's  Response
Dear patient
navicular fracture it's a rare injury. If fracture fragment Small like in your case of 8 mm it can easily conserved if fragment is not displaced. But in your case fragment is small and rotated means it will need to be fixed or removed. removal of such small fragment will not lead to any future complications. If tried to fix it may not unite.
you can weight bear on air cast and it will not cause any problems.Walking should be done t maintain muscle activities.
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How Common Is Removal Of Navicular Chip Fracture Fragments?

Dear patient navicular fracture it s a rare injury. If fracture fragment Small like in your case of 8 mm it can easily conserved if fragment is not displaced. But in your case fragment is small and rotated means it will need to be fixed or removed. removal of such small fragment will not lead to any future complications. If tried to fix it may not unite. you can weight bear on air cast and it will not cause any problems.Walking should be done t maintain muscle activities.