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Overview<br>An accessory navicular is an extra bone that is on the inner center arch of the foot. Up to 2.5% of individuals are born with the accessory navicular. Throughout early childhood, this condition is not noticed. However, in adolescence, when the accessory navicular begins to calcify, the bump on the inner aspect of the arch becomes noticed. For most, it is never symptomatic. However, for some, there is some type of injury, whether a twist, stumble, or fall, that makes the accessory navicular symptomatic.<br><br><br><br>Causes<br>Accessory navicular syndrome as it is called can result from a number of causes, excess or overuse syndrome as seen in an athlete. Trauma to the foot as in an ankle sprain or direct trauma to the navicular bone. chronic irritation from shoes rubbing against the extra bone, over time, may cause pain. Excessive pronation which strains the attachment of tibialis posterior muscles into the navicular bone. Keep in mind, the larger the actual accessory bone, the greater the chance of it becoming an issue.<br><br>Symptoms<br>One obvious problem with the accessory navicular is that it may be large and stick out from the inside of the foot. This can cause it to rub against shoes and so become quite painful. The fibrous connection between the accessory navicular and the navicualar, as well, is easy to injure, also leading to pain. This is kind of like a fracture, and such injuries cause the bone to move around too easily, leading to pain with activity. When the connection between the bones is injured in this way, the two bones do not always heal properly, so pain may continue unabated.<br><br>Diagnosis<br>To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff  evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays can usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, [http://nebulousdetenti99.sosblogs.com/ heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Most cases of accessory navicular syndrome may be treated conservatively with some sort of immobilization. This should allow the fibrous tissue between the two bones to heal. If a patient is extremely flat footed (pronated) then I lean more towards an orthotic than a boot as my main goal is to keep the patient's foot from flattening out too much and thus reduce the strain on the two bones. Supplementation with ice, oral anti-inflammatory medication. If the patient is athletic sometimes we can keep them active with an orthotic, but other times they have to give up their sport for a period of time to allow the condition to heal.<br><br><br><br>Surgical Treatment<br>The Kidner procedure involves resecting the prominent accessory navicular and ensuring that the posterior tibial tendon is still attached to the bone. Often the prominent bone can simply be shelled out from its position relative to the posterior tibial tendon, which leaves the tendon intact. However, if the tendon is loose and floppy once the extra bone has been removed, suturing or tother is required as a means of attaching it into the remaining navicular bone.
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Overview<br>The navicular bone is located on the top of the foot near the arch. People who have this extra bone can feel a bump or bony protuberance on the top of the foot above the arch. While the bone itself does not cause pain, accessory navicular syndrome can develop when the bone and/or nearby tendon is irritated. The navicular bone is attached to muscles, ligaments and the posterior tibial tendon. Since ligaments and tendons have poor blood supply and don?t heal easily, any irritation to the surrounding structures can develop into a painful condition.<br><br><br><br>Causes<br>Just having an accessory navicular bone is not necessarily a bad thing. Not all people with these accessory bones have symptoms. Symptoms arise when the accessory navicular is overly large or when an injury disrupts the fibrous tissue between the navicular and the accessory navicular. A very large accessory navicular can cause a bump on the instep that rubs on your shoe causing pain.<br><br>Symptoms<br>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.<br><br>Diagnosis<br>To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff  evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays can usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, [http://Alex8hanson.soup.io/post/594574376/Hammer-Toe-Bone-Fusion heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Treating accessory navicular syndrome is focused on relieving symptoms. Some treatment methods are Icing to reduce swelling. Immobilization with a cast or walking boot to reduce inflammation and promote healing. Medications to reduce pain and inflammation. Physical therapy to strengthen muscles. Orthotics to support the arch. Surgery may be needed to remove the accessory bone and reshape the area if other methods are not successful.<br><br><br><br>Surgical Treatment<br>After the anesthesia is administered you will be heavily sedated and placed on your stomach. Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot. The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed. Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed. A splint will be placed on the foot for stabilization and immobilization. You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist. Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication. Use narcotic pain medications before bed or if numbness in your foot begins to dull. Schedule a post-op visit for 4 weeks after the procedure.

Última revisión de 12:42 12 jun 2017

Overview
The navicular bone is located on the top of the foot near the arch. People who have this extra bone can feel a bump or bony protuberance on the top of the foot above the arch. While the bone itself does not cause pain, accessory navicular syndrome can develop when the bone and/or nearby tendon is irritated. The navicular bone is attached to muscles, ligaments and the posterior tibial tendon. Since ligaments and tendons have poor blood supply and don?t heal easily, any irritation to the surrounding structures can develop into a painful condition.



Causes
Just having an accessory navicular bone is not necessarily a bad thing. Not all people with these accessory bones have symptoms. Symptoms arise when the accessory navicular is overly large or when an injury disrupts the fibrous tissue between the navicular and the accessory navicular. A very large accessory navicular can cause a bump on the instep that rubs on your shoe causing pain.

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
To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays can usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, heel spurs and plantar fasciitis, it?s important to seek treatment.

Non Surgical Treatment
Treating accessory navicular syndrome is focused on relieving symptoms. Some treatment methods are Icing to reduce swelling. Immobilization with a cast or walking boot to reduce inflammation and promote healing. Medications to reduce pain and inflammation. Physical therapy to strengthen muscles. Orthotics to support the arch. Surgery may be needed to remove the accessory bone and reshape the area if other methods are not successful.



Surgical Treatment
After the anesthesia is administered you will be heavily sedated and placed on your stomach. Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot. The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed. Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed. A splint will be placed on the foot for stabilization and immobilization. You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist. Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication. Use narcotic pain medications before bed or if numbness in your foot begins to dull. Schedule a post-op visit for 4 weeks after the procedure.

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