06
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Recovery From Accessory Navicular Bone Removal
06.05.2017 02:28
Overview

The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people.

Accessory Navicular Syndrome

Causes

People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse.

Symptoms

Symptoms of accessory navicular syndrome often appear in adolescence, when bones are maturing. Symptoms include A visible bony prominence on the midfoot, Redness and swelling, Vague pain or throbbing in the arch, especially after physical activity.

Diagnosis

An initial assessment is an orthopaedic office begins with a thorough history and complete physical exam, including an assessment of the posterior tibial tendon and areas of tenderness. Associated misalignments of the ankle and foot should be noted. Finally, weight-bearing x-rays of the foot will help in making the diagnosis. Sometimes, an MRI may be needed to see if the posterior tibial tendon is involved with the symptoms or getting more clarity on the anatomy of the accessory navicular.

Non Surgical Treatment

Most doctors will try to find a non-surgical approach to the issue due to costs and complications involved in a surgery. Some non-surgical procedures are: Immobilization which consists of placing the foot in a cast or walking boot to allow rest and decrease inflammation, placing a towel-covered-icepack on the area to reduce inflammation, anti-inflammatory or steroid drugs/injections may be prescribed to reduce swelling and pain, physical therapy may be used to help strengthen muscles and prevent a reoccurrence of symptoms, Orthotic Devices placed in the shoe to help support the arch and prevent a reoccurrence of symptoms.

Accessory Navicular Syndrome

Surgical Treatment

If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.

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