Navicular and fifth metatarsal base stress fractures: An illustrated anatomical review.

Knee Surg Sports Traumatol Arthrosc · Sep 2026 · Review

Liu X, Hong CC, Reina F, Carrera A, Alcolea-Madera E, Del Vecchio JJ, et al.

Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health…

Foot & Ankle Orthopaedic Trauma

SUMMARY — THE REDUCTIONIllustrated anatomical review of navicular and proximal fifth metatarsal stress fractures, explaining how anatomy, loading, and limited blood supply drive delayed healing and nonunion, to guide diagnosis and treatment.
Abstract, as published

The navicular bone and the proximal fifth metatarsal (M5) play a vital role in maintaining the structural integrity and biomechanical stability of the foot's medial and lateral columns, respectively. Both bones' unique anatomical configuration, intricate mechanical environment and limited vascular supply make specific locations particularly vulnerable to stress fractures. Moreover, the combination of mechanical loading patterns and restricted perfusion in the navicular and proximal M5 further contributes to delayed healing, nonunion and refracture. Therefore, finding suitable treatment options for the different damage patterns involving both bones is critical for reducing complications and improving clinical results. This paper aims to clarify the anatomical and biomechanical features underlying these fractures to improve diagnosis, prevention, and clinical management in high-risk populations. LEVEL OF EVIDENCE: N/A.

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