Medial-sided Stress Fractures: Medial Malleolus and Navicular Stress Fractures

Although medial-sided stress fractures of the foot and ankle are a relatively uncommon injury, the delay in diagnosis and improper treatment can cause long-term pain and functional loss. Evaluation of medial-sided foot and ankle pain in the athlete prompts careful consideration and merits a heightened awareness of subtle stress injuries. Once the diagnosis is made, treatment for both navicular and medial malleolus stress fractures are hotly debated—ranging from a simple reduction in sports activities to strict non–weight bearing to operative intervention. In this technique guide, we sought not only to provide techniques for treating these uncommon stress fractures, but also to supplement this with diagnostic criteria, the current state of evidence-based practice, and the clinical rationale for such treatment modalities.