Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with insidious onset of dorsal midfoot pain in the left foot, exacerbated by weight-bearing activities and high-impact loading. Reports no history of acute trauma. Pain is localized to the "N-spot" and worsens with athletic activity, improving with rest. No nocturnal pain or constitutional symptoms noted.
Clinical Examination Findings
Left foot examination reveals localized tenderness upon palpation of the dorsal navicular bone. Minimal soft tissue swelling noted. No erythema or ecchymosis. Pain reproduced with resisted inversion and plantarflexion. Gait analysis demonstrates an antalgic limp favoring the lateral border of the foot. Neurovascular status intact distally.
Treatment Protocol
Initiate strict non-weight-bearing status for 6-8 weeks using a short leg cast or CAM boot. Recommend transition to physical therapy for gait training and gradual loading once radiographic healing is confirmed. Consider bone stimulator if delayed union is suspected. NSAIDs avoided due to potential inhibition of osteoblastic activity.