Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Ankle / Foot
Abstract number: 24250
RADIOGRAPHIC ANALYSIS IN NAVICULAR FRACTURE CARE
Marlon COULIBALY 1 , Clifford JONES 2 , Debra SIETSEMA 2 , James RINGLER 2 ,
Terrence ENDRES 2
1 Orthopaedic Research Fellowship, Grand Rapids Medical Education and Research
Center, Michigan State University; University Hospital Bergmannsheil GmbH,
Bochum (GERMANY), 2 Michigan State University, College of Human Medicine,
Department of Surgery, Grand Rapids (UNITED STATES)
Background: Navicular fractures (NF) are uncommon. The purpose of this study was
to evaluate radiographic measures after non-operative and operative treatment of
NF.Methods: A retrospective analysis was undertaken on 87 patients diagnosed with
NF between 2002 and June 2007 at a Level I teaching trauma center. Radiographic
measures were Medial-Column-Length (MedCol), Lateral-Column-Length (LatCol),
Lateral-Talometatarsal-Angle (LTM), Calcaneal-Pitch-Angle (LCP), Navicular-
Coverage-Angle (NCA), Cuboid- and Navicular-Ground-Distance (CD/ND). Clinical
outcome was pain, level-of-activity (LOA), and shoe wear.Results: Sixty-Nine patients
with 70 fractures were included. The age averaged 39 years (17-72) and BMI 28.5
(18.7-48.9). AO/OTA-07 classification types included 50 83-A and 20 83-B.
Treatment was non-operative (43) or operative (ORIF, 27). Pain was present in 32
patients. 19 patients did not return to previous LOA and 20 needed customized
shoes. Radiographic measures were MedCol 53±7mm, LatCol 33±5mm, LTM 3±9°,
LCP 20±6°, NCA 9±7°, CD 25±6mm, and ND 41±8mm. Rad iographic measures
were not significantly different between treatment groups (p>0.05). 15 flatfoot and 18
cavus deformities were identified. Cavus had decreased medial column length
(t=2.446, p=0.017) and associated with ORIF (chi-square, p=0.023). Radiographic
measures did not relate to clinical outcome. Conclusions: Navicular fractures are
uncommon and the sequelae are undetermined. Weight bearing imaging and
standardized radiographic measures are useful to radiographically identify foot
deformity in NF care. However, radiographic measures did not relate to clinical
outcome, but operative treatment was prone to cavus deformity.
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