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The middle third of the bone lacks blood vessel penetration and it bears the majority of the load applied to the tarsal bones during weight bearing. Its vascular and biomechanical properties make it susceptible to injury. This may partly explain a higher risk of stress fractures and osteonecrosis in this location.
A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. [1] [2]The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.
The first mechanism is a stress fracture which happens commonly in athletes, [7] and the other mechanism is a high energy trauma. The navicular bone is a keystone of the foot: it is part of the coxa pedis and articulates with the talus, first, second and third cuneiform, cuboid and calcaneus.
Stress fractures most frequently occur in weight-bearing bones of the lower extremities, such as the tibia and fibula (bones of the lower leg), calcaneus (heel bone), metatarsal and navicular bones (bones of the foot). Less common are stress fractures to the femur, pelvis, sacrum, lumbar spine (lower back), hips, hands, and writs. Stress ...
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or swelling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion and the way the patient walks may also be evaluated.
This bone ossification usually begins within the first 18 to 24 months of a female's life and the first 24 to 30 months of a male's life. Ossification will occur more slowly on the tarsal navicular bone than on other bones of the foot. This causes an overall loss of blood supply in the areas surrounding, as a result of the compression. [5]
March fracture is the fracture of the distal third of one of the metatarsal bones occurring because of recurrent stress. It is more common in soldiers, but also occurs in hikers, organists, and other people whose duties entail much standing (such as hospital doctors).
Fractures in the proximal third have a high incidence of AVN (~30%) Waist fractures in the middle third is the most frequent fracture site and has moderate risk of AVN. Fractures in the distal third are rarely complicated by AVN. Non union can also occur from undiagnosed or undertreated scaphoid fractures. Arterial flow to the scaphoid enters ...