Nutcracker Fracture
DiffDx Navicular fracture, navicular stress fracture, Lisfranc fracture, talar head fracture
Management Avulsions: one week of non-weight bearing, elevation followed by progressive weight bearing and functional rehab. Displaced and/or compression fracture: open reduction and internal fixation and possible bone grafting to prevent late painful arthritis
Complications Stiffness, non-union, osteonecrosis, deformity, postraumatic arthritis; untreated displaced/compression fractures can lead to relative shortening of the lateral column, planus and abduction deformities of the midfoot and chronic pain