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Surgery for navicular stress fracture

Discussion in 'Foot Surgery' started by Cameron, Mar 4, 2008.

  1. Cameron

    Cameron Well-Known Member


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    Yao Ming, the Chinese giant who plays for Houston Rockets is opting for surgery for what is described as a stress fracture of his navicular bone in his foot which has prompted podiatric physician and surgeon Dr. Michael Nirenberg to warn Ming to reconsider his decision for surgery.

    http://www.prlog.org/10054254-surgery-not-the-answer-to-ming-foot-problem.html

    Is surgery a valid option ?

    toeslayer
     
  2. Re: surgery for fractured navicular

    In a professional athlete...definitely!
     
  3. Cameron

    Cameron Well-Known Member

    Re: surgery for fractured navicular

    Thanks Kevin

    There is obviously a lot riding on this young man and not just because he is a Rocket, but he is arguably the best known Chineses athlete and high profile personality for the Olympics.

    toeslayer
     
  4. drsarbes

    drsarbes Well-Known Member

    Re: surgery for fractured navicular

    " as a stress fracture of his navicular bone "

    Well, normally surgery is not indicated for a true stress fracture.

    That being said (and having seen athletes who's conditions were erroneously described by the media) I doubt if Yao has a classic navicular stress fracture. I think it would be a bit presumptuous for anyone here (yes, even Kevin! haha) to give any meaningful advice.

    Show us an X-ray!

    Steve
     
  5. Re: surgery for fractured navicular


    Cameron:

    As I mentioned above, surgery is definitely one of the considerations for navicular fractures. Typically, a screw will be placed across the fracture site to compress it and bring about faster healing, with optional bone graft placement at the fracture site. Surgery wil tend to be a more likely treatment option in the high-end professional athlete that needs to return to their sport as quickly as possible. For the average recreational athlete, however, surgery would not be as commonly performed, unless conservative treatment had failed.

    Here is an excellent article from American Family Physician on conservative and surgical treatment treatment of navicular fractures. http://www.aafp.org/afp/20030101/85.html You will note in the article that surgical repair will return the athlete back to their sport an average of 1.8 months sooner than conservative treatment of a navicular fracture. In Yao's case, this 1.8 months of non-playing time works out to about $2.25 million in non-playing salary for the owners. No wonder he is having surgery!!
     
  6. Cameron

    Cameron Well-Known Member

    Re: surgery for fractured navicular

    Steve


    >and having seen athletes who's conditions were erroneously described by the media)................... to give any meaningful advice............Show us an X-ray!

    Fair comment. (case in point read the last paragraph of this article http://nationalpost.pa-sportsticker.com/default.aspx?s=nba-news-display&nid=A161842651204592083A)

    Appears Yeo had surgery and is expected to recover for the Games.

    http://english.people.com.cn/90001/90779/90870/6365653.html

    toeslayer
     
  7. Cameron

    Cameron Well-Known Member

    Cheers Kev, most helpful

    toeslayer
     
  8. drsarbes

    drsarbes Well-Known Member

    Hi Kevin:
    Thanks for the link.
    Is it just me or do you find the results given in Table 2 (results of treatment) very confusing.

    How can 86% of 22 patients return to normal activity in 5.6 months after treatment with > 6 wks of nonwt bearing and yet 69% of 13 patients treated with only 2-5 weeks of nonwt bearing return in only 3.7 months???

    If they are comparing treatment outcomes from different clinics...well, this really is not proper is it?

    Also for the surgery results... what is 83% of 6?

    I have to admit, as much as I like performing surgery....I have never fixated a stress fracture of the Navicular.

    Perhaps it's semantics...but if I see a fracture line through a Navicular I call it a fracture - not a "stress" fracture. I realize the nomenclature involved in trying to identify the etiology on repeated stress, but still, a fracture is a fracture and calling these a "stress" fracture doesn't do them justice (my opinion)

    In any event.... The Yao surgery is done and he most likely would have done just as well with a bone stim.

    Steve
     
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