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		<title>Does Accessory Navicular Syndrome Merit Surgery - Historial de revisiones</title>
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		<updated>2026-05-03T21:11:22Z</updated>
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		<id>http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Does_Accessory_Navicular_Syndrome_Merit_Surgery&amp;diff=10682&amp;oldid=prev</id>
		<title>YTNKathaleen en 17:50 11 jun 2017</title>
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				<updated>2017-06-11T17:50:44Z</updated>
		
		<summary type="html">&lt;p&gt;&lt;/p&gt;
&lt;table class='diff diff-contentalign-left'&gt;
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				&lt;td colspan='2' style=&quot;background-color: white; color:black; text-align: center;&quot;&gt;← Revisión anterior&lt;/td&gt;
				&lt;td colspan='2' style=&quot;background-color: white; color:black; text-align: center;&quot;&gt;Revisión de 17:50 11 jun 2017&lt;/td&gt;
				&lt;/tr&gt;&lt;tr&gt;&lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Línea 1:&lt;/td&gt;
&lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Línea 1:&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class='diff-marker'&gt;−&lt;/td&gt;&lt;td style=&quot;color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;Overview&amp;lt;br&amp;gt;The accessory navicular is an &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;ossicle, or &lt;/del&gt;extra bone located &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;medially to &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;navicular&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Depending on &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;type&lt;/del&gt;, &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;or stage, it may be connected to the &lt;/del&gt;navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;by a fibrous union, via a type &lt;/del&gt;of &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;joint called a synchrondrosis&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;In those &lt;/del&gt;who have this extra bone&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;, it is present at birth, but it starts &lt;/del&gt;as &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;soft cartilage &lt;/del&gt;and &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;then begins to ossify &lt;/del&gt;(&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;turn into bone&lt;/del&gt;) &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;at around age nine&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Some sources believe that&lt;/del&gt;, &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;in about half &lt;/del&gt;of &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;those who have it, the bone will fuse to &lt;/del&gt;the navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;in late adolescence, but it is not clear that this actually happens&lt;/del&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Causes&amp;lt;br&amp;gt;&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Just having &lt;/del&gt;an accessory navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;bone is not necessarily a bad thing&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Not all &lt;/del&gt;people &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;with these accessory bones &lt;/del&gt;have symptoms. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Symptoms arise when the accessory &lt;/del&gt;navicular is &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;overly large or when an injury disrupts &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;fibrous tissue between &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;navicular and the accessory navicular&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;A very large accessory navicular can cause a bump &lt;/del&gt;on the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;instep that rubs on your shoe causing pain&lt;/del&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Symptoms&amp;lt;br&amp;gt;&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Many people have accessory (&lt;/del&gt;?&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;extra?) naviculars &lt;/del&gt;(&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;figure 1&lt;/del&gt;) &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;- a prominent extra bone extending &lt;/del&gt;from the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;navicular &lt;/del&gt;bone. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Most accessory naviculars are completely asymptomatic. However, some individuals will develop pain &lt;/del&gt;on the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;inside &lt;/del&gt;of &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;their midfoot. Pain may occur from &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;pressure of &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;[http://TiaBrengettey&lt;/del&gt;.&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;bravesites.com/entries/general/Hammer-Toe-Surgery-Procedure shoe fit] ware against the prominence, irritating either the bone itself or the fibrous junction where the accessory bone meets the regular navicular&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Alternatively, the fibrous junction &lt;/del&gt;or &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;interface may become painful as a result of tension applied by &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;posterior tibial tendon through its connection &lt;/del&gt;or &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;insertion at that site.&amp;#160; Often, individuals will be asymptomatic for years, however, a new pair &lt;/del&gt;of &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;shoes or a change in their &lt;/del&gt;activity &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;level can cause symptoms&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;The accessory navicular itself typically develops &lt;/del&gt;during adolescence, &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;when the two areas of the navicular bone fail to fuse together&lt;/del&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Diagnosis&amp;lt;br&amp;gt;&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Your doctor will &lt;/del&gt;diagnose &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;an &lt;/del&gt;accessory navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;by examining your child&lt;/del&gt;?s foot. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Your physician may also obtain x&lt;/del&gt;-rays &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;to &lt;/del&gt;confirm the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;accessory &lt;/del&gt;navicular and to &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;rule out other conditions&lt;/del&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Non Surgical Treatment&amp;lt;br&amp;gt;&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Treating &lt;/del&gt;accessory navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;syndrome is focused on relieving symptoms. Some treatment methods are Icing to reduce swelling. Immobilization &lt;/del&gt;with &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;a cast &lt;/del&gt;or &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;walking &lt;/del&gt;boot &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;to reduce inflammation and promote healing&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Medications to reduce pain and &lt;/del&gt;inflammation&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;. Physical therapy &lt;/del&gt;to &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;strengthen muscles&lt;/del&gt;. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Orthotics to &lt;/del&gt;support &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;the &lt;/del&gt;arch. &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;Surgery may be needed to remove &lt;/del&gt;the accessory bone &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;and reshape &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;area if other methods are &lt;/del&gt;not &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;successful&lt;/del&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Surgical Treatment&amp;lt;br&amp;gt;&lt;del class=&quot;diffchange diffchange-inline&quot;&gt;The above non-surgical options should be enough to treat accessory navicular syndrome. If they fail&lt;/del&gt;, &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;a surgery would be necessary to remove &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;extra bone that has been causing &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;problems&lt;/del&gt;. The &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;most common &lt;/del&gt;procedure &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;for this condition &lt;/del&gt;is &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;known &lt;/del&gt;as the Kidner procedure &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;where a small incision is made over the navicular bone&lt;/del&gt;. The accessory &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;navicular is identified &lt;/del&gt;and &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;dissected free from &lt;/del&gt;the posterior tibial tendon. The &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;posterior tibial &lt;/del&gt;tendon &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;is &lt;/del&gt;then &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;reattached to &lt;/del&gt;the &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;remaining &lt;/del&gt;navicular &lt;del class=&quot;diffchange diffchange-inline&quot;&gt;bone&lt;/del&gt;.&lt;/div&gt;&lt;/td&gt;&lt;td class='diff-marker'&gt;+&lt;/td&gt;&lt;td style=&quot;color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;Overview&amp;lt;br&amp;gt;The accessory navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;(os navicularum or os tibiale externum) &lt;/ins&gt;is an extra bone &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;or piece of cartilage &lt;/ins&gt;located &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;on &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;inner side of the foot just above the arch&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;It is incorporated within &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;posterior tibial tendon&lt;/ins&gt;, &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;which attaches in this area. An accessory &lt;/ins&gt;navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;is congenital (present at birth). It is not part &lt;/ins&gt;of &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;normal bone structure and therefore is not present in most people&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;People &lt;/ins&gt;who have &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;an accessory navicular often are unaware of the condition if it causes no problems. However, some people with &lt;/ins&gt;this extra bone &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;develop a painful condition known &lt;/ins&gt;as &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;accessory navicular syndrome when the bone &lt;/ins&gt;and&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;/or posterior tibial tendon are aggravated. Many people with accessory navicular syndrome also have flat feet &lt;/ins&gt;(&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;fallen arches&lt;/ins&gt;). &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Having a flat foot puts more strain on the posterior tibial tendon&lt;/ins&gt;, &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;which can produce inflammation or irritation &lt;/ins&gt;of the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;accessory &lt;/ins&gt;navicular.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Causes&amp;lt;br&amp;gt;&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;This painful foot condition is caused by &lt;/ins&gt;an &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;extra bone in the foot called the &lt;/ins&gt;accessory navicular. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Only about 10% of &lt;/ins&gt;people have &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;this bone (4 to 21%), and not all of them will develop any &lt;/ins&gt;symptoms. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;The &lt;/ins&gt;navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;bone &lt;/ins&gt;is &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;one of &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;normal tarsal bones of &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;foot&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;It is located &lt;/ins&gt;on the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;inside of the foot, at the arch&lt;/ins&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Symptoms&amp;lt;br&amp;gt;&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;What are the signs/symptoms of Accessory Navicular Syndrome&lt;/ins&gt;? &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Pain in the foot following trauma &lt;/ins&gt;(&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;such as after an ankle sprain&lt;/ins&gt;) &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Chronic irritation &lt;/ins&gt;from &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;shoes or other footwear rubbing against &lt;/ins&gt;the bone. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;A visible bony prominence &lt;/ins&gt;on the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;inner side &lt;/ins&gt;of the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;foot just above &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;arch&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Redness and swelling of that area&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Vague pain &lt;/ins&gt;or &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;throbbing in &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;arch mostly occuring during &lt;/ins&gt;or &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;after periods &lt;/ins&gt;of &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;physical &lt;/ins&gt;activity. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Symptoms appear most often &lt;/ins&gt;during adolescence, &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;but some may not occur until adulthood&lt;/ins&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Diagnosis&amp;lt;br&amp;gt;&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;To &lt;/ins&gt;diagnose accessory navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;syndrome, medical staff ask about the patient&lt;/ins&gt;?s &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;activities and symptoms. They will examine the &lt;/ins&gt;foot &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;for irritation or swelling&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Medical staff&amp;#160; evaluate the bone structure, muscle, joint motion, and the patient?s gait. X&lt;/ins&gt;-rays &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;can usually &lt;/ins&gt;confirm the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;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 &lt;/ins&gt;navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;accessory bone irritation can lead to bunions, [http://Exciteddaybook567.Soup.io/post/594503721/Hammer-Toe-Issues heel spurs] &lt;/ins&gt;and &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;plantar fasciitis, it?s important &lt;/ins&gt;to &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;seek treatment&lt;/ins&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Non Surgical Treatment&amp;lt;br&amp;gt;&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Treatment of the &lt;/ins&gt;accessory navicular &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;begins &lt;/ins&gt;with &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;rest, which may include activity modification &lt;/ins&gt;or &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;temporary immobilization in a &lt;/ins&gt;boot &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;or a brace&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Once the &lt;/ins&gt;inflammation &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;subsides the foot needs &lt;/ins&gt;to &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;be supported&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;The &lt;/ins&gt;support &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;consists of a specially designed orthotic &lt;/ins&gt;arch &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;support&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;Occasionally, the orthotic will dig into the edge of &lt;/ins&gt;the accessory &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;navicular &lt;/ins&gt;bone &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;under &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;arch of the foot. This is very uncomfortable. For this reason the orthotic support needs to be carefully made. The orthotic support will help control (but &lt;/ins&gt;not &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;cure) the flat foot and will often decrease the inflammation on the navicular&lt;/ins&gt;.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Surgical Treatment&amp;lt;br&amp;gt;&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;In the original Kidner procedure&lt;/ins&gt;, the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;entire posterior tibial tendon was released from &lt;/ins&gt;the &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;navicular and then rerouted through a drill hole placed through the navicular&lt;/ins&gt;. The &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;original Kidner &lt;/ins&gt;procedure is &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;now rarely used &lt;/ins&gt;as &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;a means of treating an isolated accessory navicular. Instead, a modification of &lt;/ins&gt;the Kidner procedure &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;has become more commonplace&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt; &lt;/ins&gt;The &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;modified Kidner procedure consists of carefully removing the &lt;/ins&gt;accessory and &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;anchoring &lt;/ins&gt;the posterior tibial tendon &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;to the surface of the navicular where the accessory was removed&lt;/ins&gt;. &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt; &lt;/ins&gt;The &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;repair may be done by passing a suture through the &lt;/ins&gt;tendon &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;and &lt;/ins&gt;then &lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;through drill holes in &lt;/ins&gt;the navicular&lt;ins class=&quot;diffchange diffchange-inline&quot;&gt;, or by using a suture anchor&lt;/ins&gt;.&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;/table&gt;</summary>
		<author><name>YTNKathaleen</name></author>	</entry>

	<entry>
		<id>http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Does_Accessory_Navicular_Syndrome_Merit_Surgery&amp;diff=6204&amp;oldid=prev</id>
		<title>VinceLoera: Página creada con «Overview&lt;br&gt;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...»</title>
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				<updated>2017-06-10T12:01:00Z</updated>
		
		<summary type="html">&lt;p&gt;Página creada con «Overview&amp;lt;br&amp;gt;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...»&lt;/p&gt;
&lt;p&gt;&lt;b&gt;Página nueva&lt;/b&gt;&lt;/p&gt;&lt;div&gt;Overview&amp;lt;br&amp;gt;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.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Causes&amp;lt;br&amp;gt;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.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Symptoms&amp;lt;br&amp;gt;Many people have accessory (?extra?) naviculars (figure 1) - a prominent extra bone extending from the navicular bone. Most accessory naviculars are completely asymptomatic. However, some individuals will develop pain on the inside of their midfoot. Pain may occur from the pressure of the [http://TiaBrengettey.bravesites.com/entries/general/Hammer-Toe-Surgery-Procedure shoe fit] ware against the prominence, irritating either the bone itself or the fibrous junction where the accessory bone meets the regular navicular. Alternatively, the fibrous junction or interface may become painful as a result of tension applied by the posterior tibial tendon through its connection or insertion at that site.  Often, individuals will be asymptomatic for years, however, a new pair of shoes or a change in their activity level can cause symptoms. The accessory navicular itself typically develops during adolescence, when the two areas of the navicular bone fail to fuse together.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Diagnosis&amp;lt;br&amp;gt;Your doctor will diagnose an accessory navicular by examining your child?s foot. Your physician may also obtain x-rays to confirm the accessory navicular and to rule out other conditions.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Non Surgical Treatment&amp;lt;br&amp;gt;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.&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;&amp;lt;br&amp;gt;Surgical Treatment&amp;lt;br&amp;gt;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.&lt;/div&gt;</summary>
		<author><name>VinceLoera</name></author>	</entry>

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