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Does Accessory Navicular Syndrome Always Need Surgery


Overview
For most people with an accessory navicular, the extra bone does 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 Syndrome

Causes
It is commonly believed that the posterior tibial tendon loses its vector of pull to heighten the arch. As the posterior muscle contracts, the tendon is no longer pulling straight up on the navicular but must course around the prominence of bone and first pull medially before pulling upward. In addition, the enlarged bones may irritate and damage the insertional area of the posterior tibial tendon, making it less functional. Therefore, the presence of the accessory navicular bone does contribute to posterior tibial dysfunction.

Symptoms
The primary reason an accessory navicular becomes a problem is pain. There is no need to Do compression socks help with Achilles tendonitis? anything with an accessory navicular that is not causing pain. The pain is usually at the instep area and can be pinpointed over the small bump in the instep. Walking can be painful when the problem is aggravated. As stated earlier, the condition is more common in girls. The problem commonly becomes symptomatic in the teenage years.

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
Patients with a painful accessory navicular may benefit with four to six physical therapy treatments. Your therapist may design a series of stretching exercises to try and ease tension on the posterior tibial tendon. A shoe insert, or orthotic, may be used to support the arch and protect the sore area. This approach may allow you to resume normal walking immediately, but you should probably cut back on more vigorous activities for several weeks to allow the inflammation and pain to subside. Treatments directed to the painful area help control pain and swelling. Examples include ultrasound, moist heat, and soft-tissue masغير مجاز مي باشدe. Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area.

Accessory Navicular

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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Pain After Accessory Navicular Surgery


Overview
The accessory navicular is an ossicle, or extra bone located medially to the navicular. Depending on the type, or stage, it may be connected to the navicular by a fibrous union, via a type of joint called a synchrondrosis. In those who have this extra bone, it is present at birth, but it starts as soft cartilage and then begins to ossify (turn into bone) at around age nine. Some sources believe that, in about half of those who have it, the bone will fuse to the navicular in late adolescence, but it is not clear that this actually happens.

Accessory Navicular

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
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
Diagnosis starts by speaking with the patient about symptoms. The physician will look at the foot and examine it for signs of an accessory navicular. By putting pressure on the area, the doctor may determine its presence simply by the presence of pain. The muscle, joint, and the overall structure of the foot may be considered, as well as the way in which the patient walks. If a diagnosis of accessory navicular syndrome is made, an X-ray or MRI may be ordered to confirm diagnosis.

Non Surgical Treatment
Traditional medicine often falls short when it comes to treatment for this painful condition. As similar to other chronic pain conditions, the following regimen is usually recommended: RICE, immobilization, anti-inflammatory medications, cortisone injections, and/or innovative surgical options. Clients familiar with Prolotherapy often say? no thanks? to those choices, as they know these treatments will only continue to weaken Can stretching help you grow taller? the area in the foot. Instead, they choose Prolotherapy to strengthen the structures in the medial foot.

Accessory Navicular

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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برچسب: How long does it take to recover from Achilles injury?، What do eccentric heel drops do?، Do you get taller when you stretch?،
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