title: Tarsal navicular stress fractures.
abstract: OBJECTIVE
  Navicular stress fractures are common in athletes and management is debated. This article will review the evaluation and management of navicular stress fractures.
  
  
  RESULTS
  Various operative and non-operative adjunctive treatment modalities are reviewed including the relevance of vitamin D levels, use of shock wave therapy and bone marrow aspirate concentrate (BMAC), and administration of teriparatide. Surgical treatment may be associated with earlier return to sports. The author's preferred treatment algorithm with corresponding images is presented which allows for safe and rapid return to activities in the athletic patient. Future research is needed in evaluating the preventative effects of vitamin D and use of other adjunctive treatments to increase the healing rates of this fracture.
authors.affiliation: Rothman Institute, 3300 Tillman Drive, 2nd Floor, Bensalem, PA, 19020-2071, USA. Rachel.shakked@rothmaninstitute.com.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Shakked
authors.affiliation: University of Texas McGovern Medical School, Houston, TX, USA.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Walters
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: O'Malley
keywords: Navicular; Stress fracture; Vitamin D