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Overview<br>An accessory navicular bone is an accessory bone of the foot that occasionally develops abnormally causing a plantar medial enlargement of the navicular. The accssory navicular bone presents as a sesamoid in the posterior tibial tendon, in articulation with the navicular or as an enlargment of the navicular. Navicular (boat shaped) is an intermediate tarsal bone on the medial side of the foot. It is located on the medial side of the foot, and articulates proximally with the talus. Distally it articulates with the three cuneiform bones. In some cases it articulates laterally with the cuboid. The tibialis posterior inserts to the os naviculare. The tibialis posterior muscle also contracts to produce inversion of the foot and assists in the plantar flexion of the foot at the ankle. Tibialis posterior also has a major role in supporting the medial arch of the foot. This supports is compromised by abnormal insertion of the tendon into the accessory navicular bone when present. This lead to loss of suspension of tibialis posterior tendon and may cause peroneal spastic pes planus or simple pes planus. But, yet a cause and effect relationship between the accessory navicular and pes planus is doubtful and is yet unproved clearly.<br><br><br><br>Causes<br>An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.<br><br>Symptoms<br>Adolescence is a common time for the symptoms to first appear. This is a time when bones are maturing and cartilage is developing into bone. Sometimes, however, the symptoms do not occur until adulthood. The signs and symptoms of accessory navicular syndrome include A visible bony prominence on the midfoot (the inner side of the foot, just above the arch) Redness and swelling of the bony prominence. Vague pain or throbbing in the midfoot and arch, usually occurring during or after periods of activity.<br><br>Diagnosis<br>Upon examining a foot with a symptomatic accessory navicular, there will often be a bony prominence on the inside of the foot, just below and in front of the inside ankle bone (medial malleolus). The size of this prominence will vary from small to quite large. Pressing over this area will often cause discomfort. There may be an associated flat foot deformity as this can occur in patients with an accessory navicular. Stressing the posterior tibial tendon by raising the heel up and down on one foot, or by forcing the foot to the inside against resistance, may aggravate the symptoms as these maneuvers stress the posterior tibial tendon which is attached on the inside of the accessory navicular bone. Patients may walk with a slight limp due to the pain.<br><br>Non Surgical Treatment<br>Most children?s symptoms are improved or resolved by taking a break from activities that irritate their feet. [http://Bobettebrachman.Hatenablog.com/entry/2015/03/13/183016 shoe fit] inserts that pad the accessory navicular area are also helpful. If your child?s symptoms do not improve, your physician may recommend a below-the-knee cast or walking boot. Surgery is rarely needed.<br><br><br><br>Surgical Treatment<br>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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Overview<br>Not everyone has the same number of bones in his feet. It is not uncommon for both the hands and the feet to contain extra small accessory bones, or ossicles, that sometimes cause problems. This guide will help you understand where the accessory navicular is located, why the extra bone can cause problems and how doctors treat the condition.<br><br><br><br>Causes<br>An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.<br><br>Symptoms<br>Most people with an accessory navicular do not have symptoms because the bone is so small that it causes no harm, or only develop symptoms after a trauma such as a break or sprain. When symptoms are present they could be a visible bony prominence, pain and throbbing, inflammation and redness, and flat feet.<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://marvishertel.soup.io/post/515143654/Exercise-Routines-For-Plantar-Fasciitis-Treatment heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Treatment options for a painful accessory navicular can include anti-inflammatory medications, rest, arch support structures in the shoe, or use of a cast or splint. Severe cases may require surgery.<br><br><br><br>Surgical Treatment<br>The above non-surgical options should be enough to treat accessory navicular syndrome. If they fail, a surgery would be necessary to remove the extra bone that has been causing the problems. The most common procedure for this condition is known as the Kidner procedure where a small incision is made over the navicular bone. The accessory navicular is identified and dissected free from the posterior tibial tendon. The posterior tibial tendon is then reattached to the remaining navicular bone.

Última revisión de 01:29 12 jun 2017

Overview
Not everyone has the same number of bones in his feet. It is not uncommon for both the hands and the feet to contain extra small accessory bones, or ossicles, that sometimes cause problems. This guide will help you understand where the accessory navicular is located, why the extra bone can cause problems and how doctors treat the condition.



Causes
An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.

Symptoms
Most people with an accessory navicular do not have symptoms because the bone is so small that it causes no harm, or only develop symptoms after a trauma such as a break or sprain. When symptoms are present they could be a visible bony prominence, pain and throbbing, inflammation and redness, and flat feet.

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
Treatment options for a painful accessory navicular can include anti-inflammatory medications, rest, arch support structures in the shoe, or use of a cast or splint. Severe cases may require surgery.



Surgical Treatment
The above non-surgical options should be enough to treat accessory navicular syndrome. If they fail, a surgery would be necessary to remove the extra bone that has been causing the problems. The most common procedure for this condition is known as the Kidner procedure where a small incision is made over the navicular bone. The accessory navicular is identified and dissected free from the posterior tibial tendon. The posterior tibial tendon is then reattached to the remaining navicular bone.

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