Q: My son is a high school junior varsity basketball player who injured his foot two months ago. He saw the doctor who diagnosed a stress fracture of his navicular bone after getting X-rays and a CT scan. He was treated with a boot for six weeks and then was told the fracture had healed. My son went back to play basketball and again felt severe pain in his foot. The doctor got a new CT scan and now says the fracture has not healed and my son needs surgery to fix the navicular bone. I do not understand why the fracture did not heal and I wonder why he now needs surgery. I would appreciate some advice?
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A: The navicular bone, when injured, is very slow to heal as it has a poor micro circulation. Stress fractures can be caused by repetitive stresses and when playing basketball, this bone is subject to stresses five to seven times your body weight.
When a fracture line is present on an X-ray or CT scan, these usually require surgery to fix. It was not unreasonable to try non-surgical treatment at first, but it appears this was not successful.
Surgery usually requires placement of screws to compress the fracture site and, sometimes, occasional bone grafting, PRP or stem cells to stimulate healing, as well.
After surgery, healing can take several months and most athletes are out of basketball at least six months. If you still have questions, you may want to get a second opinion from an orthopedic foot and ankle specialist.