An Isolated Plantar Medial Navicular Dislocation Without Associated Body Fracture Following Low Energy Trauma.

Abstract

The occurrence of isolated tarsal navicular dislocation without fracture is infrequently documented in the orthopedic literature. Over the past century, there have been approximately 15 cases reported of isolated navicular dislocation without a fracture. The majority of these cases resulted from high-energy mechanisms with limited follow-up. The injury mechanism has commonly been explained as a pronation-abduction force applied to the midfoot, leading to a medial dislocation of the navicular with disruption of its ligamentous support. We present a unique case of a 57-year-old female who sustained an isolated tarsal navicular dislocation without fracture following a low-energy mechanism. She underwent successful closed reduction, followed by Kirschner wire fixation of the midfoot in the operating room. The patient was compliant with postoperative recommendations and regularly attended follow-up appointments. Significant progress was noted in pain relief and functional improvement at her 8-month follow-up. Nonetheless, certain long-term sequelae persisted, manifesting as mild chronic midfoot pain by her 15-month follow up. The low energy mechanism in this case not only deviates from what has been previously documented in the literature regarding isolated navicular dislocations but also includes thorough follow-up, a feature often lacking in similar cases.