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Open Reduction-Internal Fixation of a Navicular Body Fracture with Dorsal Displacement of the First and Second Cuneiforms

A Case Report

Robert C. Andersen Southern Arizona VA Health Care System, Tucson, Arizona.

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Katherine Neiderer Southern Arizona VA Health Care System, Tucson, Arizona.

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Billy Martin Southern Arizona VA Health Care System, Tucson, Arizona.

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James Dancho Southern Arizona VA Health Care System, Tucson, Arizona.

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Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture. (J Am Podiatr Med Assoc 103(3): 246–249, 2013)

Corresponding author: Katherine Neiderer, DPM, MPH, Southern Arizona VA Health Care System, Tucson, Arizona, 3601 S 6th Ave (2–112), Tucson, AZ 85723. (E-mail: kateneiderer@hotmail.com)