The C-shaped navicular bone is nestled between the talar head and the three cuneiforms. The bone is subject to repetitive, high-level stresses of the medial column of the foot. Navicular stress reactions/fractures are located within the central one third
Figure 70-9 An anteroposterior radiograph demonstrating the surgical repair of an isolated Lisfranc injury. The clamp has reduced the first-second metatarsal gap. The depth gauge measures the length of an appropriate screw prior to insertion.
of the bone, an area of stress concentration.22-24 Abnormal foot morphology, such as a cavus and/or forefoot adductus, may concentrate additional forces to this region. Using a microangio-graphic technique to study bone perfusion, Torg et al22 detailed a relative watershed area in the central portion of the navicular. Due to vast articular surfaces on the proximal and distal surfaces, vascular channels are restricted to the navicular's medial and lateral surfaces. Osseous perfusion is provided via the posterior tibial and the dorsal pedis arteries, respectively. The path-omechanical basis of this injury is the cumulative stresses applied to a region of decreased vascularity.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.