Management of neuropathic injury to the tarsal navicular.

The goal of treatment is to have a foot that will fit in a shoe or brace without likelihood of skin pressure and ultimate ulceration. Surgery is indicated in the acute and chronic phases of neuroarthropathy related to navicular fracture of dislocation. For patients who have acute injury with deformity that threatens the skin or cannot be maintained in a stable position without manipulation in a boot or cast, surgery with arthrodesis is recommended. Patients who subsequently develop deformities that cannot be managed successfully with extra-depth custom shoes or braces, and who are not candidates for ostectomy,. should be considered for reconstructive osteotomy and fusion. Arthrodesis is a reliable treatment for patients who cannot be managed conservatively.