Navicular bone fracture

　　1. Causes of the disease

　　Direct violence, indirect violence, and muscle traction violence can all cause injury.

　　2. Pathogenesis

　　The navicular bone located in front of the calcaneus fits with the talus head, named due to its shape resembling a boat, which transmits the force from the talus to the three cuneiform bones in front. In addition to fractures caused by direct impact violence, indirect transmission violence can also cause damage to the navicular bone, and the violent contraction of the posterior tibial muscle can cause medial avulsion fractures.

　　The healing time of navicular bone fracture is relatively long, generally requiring more than 6 weeks of absolute immobilization in a cast, and the most common complication is delayed fracture healing.
　　It is recommended to receive standardized treatment, regularly review X-rays, and gradually start functional exercises after clinical healing is confirmed.

　　1. Pain and swelling: The pain in the foot is significant during toe flexion and extension, due to the thin muscle tissue coverage in this area, local swelling and soft tissue hematomas are more pronounced.

　　2. Axial pain: Severe pain in the middle metatarsal area when pushing the 1-3 metatarsal bones longitudinally.

　　Preventing the occurrence of accidents and injuries is the key to preventing fractures. Keeping away from dangerous environments, prohibiting fighting and fighting, paying attention to protection during outdoor activities, and preparing warm-up activities before exercise are all conducive to the prevention of diseases.

　　General radiographic examination:

　　All suspected fractures should undergo routine X-ray imaging, which can reveal incomplete fractures, deep fractures, intra-articular fractures, and small avulsion fractures that are difficult to detect clinically. Even for those already manifesting obvious fractures clinically, X-ray imaging is necessary and can help understand the type and specific situation of the fracture, which is of guiding significance for treatment.

　　What foods should be avoided for talus fractures:

　　1. Avoid eating too much meat bones.

　　2. Avoid excessive sugar intake.

　　3. Avoid indigestible foods. Avoid eating foods that are easy to cause flatulence or indigestion, such as sweet potatoes, taro, glutinous rice, etc., and eat more fruits and vegetables.

　　I. Treatment

　　Treatments are carried out according to different types.

　　1. For those without displacement, leg plaster immobilization for about 6 weeks is required, and for those that have not healed, appropriate extension may be made. After the plaster is removed, functional exercises should be strengthened.

　　2. For those with displacement but can achieve satisfactory alignment, the treatment is still carried out according to the previous method after reduction.

　　3. Severe displacement cases, including those with failed reduction, all require open reduction and internal fixation, and are assisted by leg plaster immobilization.

　　(1) Fracture of the navicular body: After reduction, Kirschner wire cross-fixation can be performed.

　　(2) Navicular tubercle avulsion: For small bone fragments, they can be sutured together with the insertion of the posterior tibial muscle using a 10-0 suture, and for larger bone fragments, small screws or Kirschner wires can be used for fixation.

　　(3) Fracture of the dorsal margin of the navicular bone: For patients with difficulty in fixation after open reduction, it may be excised.

　　4. The basic principles for old injuries are similar to those for talus fractures. For those with traumatic arthritis or ischemic necrosis, joint fusion surgery may be performed according to circumstances, and the talocalcaneal joint should be preserved as much as possible during the operation, while fusing the naviculare-cuneiform joint.

　　II. Prognosis

　　Generally, the prognosis is good.