Does Accessory Navicular Syndrome Warrant Surgery

Overview
The navicular bone of the foot is one of the small bones on the mid-foot. The bone is located at the instep, the arch at the middle of the foot. One of the larger tendons of the foot, called the posterior tibial tendon, attaches to the navicular before continuing under the foot and into the forefoot. This tendon is a tough band of tissue that helps hold up the arch of the foot. If there is an accessory navicular, it is located in the instep where the posterior tibial tendon attaches to the real navicular bone.



Causes
Let us see the reasons why the tendon or the bone would get aggravated. Ankle or foot sprain, irritation of the bone caused by footwear, overusing the foot, quite common in athletes and dancers. People born with this extra bone are also known develop flat feet which also adds to the strain on the posterior tibial tendon and lead to the syndrome.

Symptoms
Symptoms of accessory navicular include. Bone lump on the inside of the foot. Redness and swelling. Pain.

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
If the foot becomes painful following a twisting type of injury and an X-ray reveals the presence of an accessory navicular bone, your doctor may recommend a period of immobilization in a cast or splint. This will rest the foot and perhaps allow the disruption between the navicular and accessory navicular to heal. Your doctor may prescribe anti-inflammatory medication. Sometimes an arch support can relieve the stress on the fragment and decrease the symptoms. If the pain subsides and the fragment becomes asymptomatic, further treatment may not be necessary.



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.