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What Is Accessory Navicular Syndrome

What Is Accessory Navicular Syndrome

Overview
For most people with an accessory navicular, the extra bone How long does it take to recover from Achilles injury? not cause any problems and most are unaware of its presence. But certain activities or circumstances may cause the extra bone or the tibialis posterior tendon that contains it to grow irritated. This is called accessory navicular syndrome, and its possible causes include sprains, overuse, or wearing shoes that constantly rub against the bone. Individuals who have a collapsed arch (commonly known as flat feet) may be at greater risk of accessory navicular syndrome, assuming they have the extra bone, because of the added daily trauma placed on the tibialis posterior tendon.

Accessory Navicular

Causes
This painful foot condition is caused by an extra bone in the foot called the accessory navicular. Only about 10% of people have this bone (4 to 21%), and not all of them will develop any symptoms. The navicular bone is one of the normal tarsal bones of the foot. It is located on the inside of the foot, at the arch.

Symptoms
Possible symptoms of accessory navicular syndrome include redness or swelling in the area of the accessory navicular, and pain that is present around the middle of the foot around the arch. Discomfort is most often present following periods of exercise or prolonged walking or standing. The bone may be somewhat visible on the inside of the foot above the arch. Most symptoms of accessory navicular syndrome first appear in childhood around the time of adolescence as the bones are still growing and developing. For some with an accessory navicular, though, symptoms may not appear until entering adulthood.

Diagnosis
Usually, you will only need an X-ray to determine the size or type of the accessory navicular bone or the amount of medial navicular tuberosity hypertrophy. Be cognizant of stress fractures which may be duplicated as a hairline fracture or increased calcification. When treating children, always look for avascular necrosis of the navicular (Kohler?s disease). An X-ray of this condition will reveal a flattening of the navicular along with increased bone density.

Non Surgical Treatment
The initial treatment approach for accessory navicular is non-operative. An orthotic may be recommended or the patient may undergo a brief period of casting to rest the foot. For chronic pain, however, the orthopedic surgeon removes the extra bone, a relatively simple surgery with a brief rehabilitation period and a very good success rate.

Accessory Navicular

Surgical Treatment
Surgical treatment of the accessory navicular syndrome with simple excision has the advantages of less invasive to the posterior tibial tenden and the medial longitudinal arch of the foot, shorter time of immobilization of the foot and stay in hospital, small incision and good clinical results. This procedure is one of the best selective treatments for the accessory navicular syndrome, especially for the patients without flatfoot deformity and old sprain injury.