Management of Tarsal Navicular Stress Fractures
| العنوان: | Management of Tarsal Navicular Stress Fractures |
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| المؤلفون: | Joseph S. Torg, James Moyer, Barry P. Boden, John P. Gaughan |
| المصدر: | The American Journal of Sports Medicine. 38:1048-1053 |
| بيانات النشر: | SAGE Publications, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Adolescent, Fractures, Stress, Radiography, MEDLINE, Physical Therapy, Sports Therapy and Rehabilitation, Bone healing, medicine.disease_cause, Weight-bearing, Weight-Bearing, Fracture Fixation, Internal, Immobilization, Young Adult, Postoperative Complications, Fracture fixation, Humans, Medicine, Orthopedic Procedures, Orthopedics and Sports Medicine, Fracture Healing, Stress fractures, business.industry, Recovery of Function, Tarsal Bones, Plastic Surgery Procedures, medicine.disease, Random effects model, Surgery, Treatment Outcome, Meta-analysis, Female, business |
| الوصف: | Purpose This study was conducted to provide a statistical analysis of previously reported tarsal navicular stress fracture studies regarding the outcomes and effectiveness of conservative and surgical management. Study Design Systematic review. Methods A systematic review of the published literature was conducted utilizing MEDLINE through Ovid, PubMed, ScienceDirect, and EBSCOhost. Reports of studies that provided the type of tarsal navicular stress fracture (ie, complete or incomplete), type of treatment, result of that treatment, and the time required to return to full activity were selected for analysis. Using a mixed generalized linear model with study as a random effect and treatment as a fixed effect, cases were separated and compared based on 3 different types of treatment: conservative, weightbearing permitted (WBR); conservative, non-weightbearing (NWB); and surgical treatment. The outcome of the treatment was recorded as either successful or unsuccessful based on radiographic and/or clinical healing of the fracture and time from onset of treatment to return to activity. Results There was no statistically significant difference between NWB conservative treatment and surgical treatment regarding outcome (P = .6441). However, there is a statistical trend favoring NWB management (96% successful outcomes) over surgery (82% successful outcomes). Weightbearing as a conservative treatment was shown to be significantly less effective than either NWB (P = .0001) or surgical treatment (P < .0003). Conclusion Non-weightbearing conservative management should be considered the standard of care for tarsal navicular stress fractures. The authors could find no advantage for surgical treatment compared with NWB immobilization. However, there is a statistical trend favoring NWB over surgery. Rest or immobilization with weightbearing was inferior to both other treatments analyzed. The authors concluded that conservative NWB management is the standard of care for initial treatment of both partial and complete stress fractures of the tarsal navicular. |
| تدمد: | 1552-3365 0363-5465 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e2145c062e1631b510443b93986a4ebe https://doi.org/10.1177/0363546509355408 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....e2145c062e1631b510443b93986a4ebe |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15523365 03635465 |
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