A Unique Procedure for Treatment of Osteochondral Lesions of the Tarsal Navicular: Three Cases in Athletes

Surgery in the athlete can present unique challenges, particularly when articular damage and osteoarthritic changes are noted. To allow athletes to return to their desired activity level, an alternative to the traditional approach of fusion must be developed. We prospectively reviewed 3 cases of osteochondral lesions and degenerative changes of the tarsal navicular joint involving a unique surgical approach consisting of microfracture of the lesions with concomitant arthrodiastasis. All 3 patients were treated with a miniexternal fixator to provide distraction for 4 weeks. The patients were aged 15, 17, and 21 years, with follow-up ranging from 2 to 4 years, at which point each patient was competing at their desired activity level and pain free. Each patient was initially treated at different stages of a navicular injury with patient 3 having undergone 2 courses of casted non-weightbearing. This new treatment gives more options to a potentially athletic career-ending injury.