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Overview<br>Some people have more bones in their feet than others. Actually, it?s not all that uncommon to have extra bones in the feet. These extra bones area called accessory bones. The navicular bone, one of the small bones located at the instep or arch of the middle of the foot, is an example of an extra bone people are born with. It?s called the accessory navicular bone. During the maturation process, the navicular and the accessory navicular never fuse into one solid bone, but remain connected by fibrous tissue or cartilage. It is estimated that 4-14% of the population are born with an accessory navicular bone.<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>Perhaps the most common of the extra bones in the foot, the accessory navicular bone is estimated to be present in 7 to 19 percent of the population. Zadek and Gold maintained that the bone persisted as a distinct, separate bone in 2 percent of the population. Also be aware that the accessory bone normally fuses completely or incompletely to the navicular. It is this incomplete fusion which allows for micromotion, which, in turn, may cause degenerative changes that can also contribute to the pain.<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://frank7rice8.sosblogs.com/ heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>In order to strengthen your muscles to prevent further injury and to provide support to the foot, your podiatrist may also outline a physical therapy routine and prescribe orthotics. Orthotics will provide support to the arch of your foot, although they must be carefully crafted in order to make room for that pesky extra bone you?ve got poking about.<br><br><br><br>Surgical Treatment<br>If conservative care does not alleviate the problem then surgical intervention should be considered. 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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Overview<br>Everyone has one navicular bone: one of the small bones of the foot. A small number of people have a second small navicular bone or piece of cartilage located on the inside of the foot just above the arch: both are simply called an "accessary navicular bone." It is located within the posterior tibial tendon which attaches in this area. It is easy to see as a "bump." Most that have it never have pain. If they get pain, we call it: "Accessary navicular bone syndrome."<br><br><br><br>Causes<br>The syndrome may result from any of the following, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against the bone. Strain from overuse or excessive activity.<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>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://margystasiak.soup.io heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Initial treatment is conservative. With the first episode of symptoms, a medial heel wedge, anti-inflammatories, and physical therapy can be helpful. If very painful, a cast or boot may be needed for a short period time before the wedge and physical therapy can be initiated. Very rarely is a steroid injection warranted or recommended. As the pain improves, patients can resume activities. For a minority of patients, an arch support or custom orthotic can help to take some of the extra pressure off of the accessory navicular and the posterior tibial tendon.<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.

Revisión de 17:37 11 jun 2017

Overview
Everyone has one navicular bone: one of the small bones of the foot. A small number of people have a second small navicular bone or piece of cartilage located on the inside of the foot just above the arch: both are simply called an "accessary navicular bone." It is located within the posterior tibial tendon which attaches in this area. It is easy to see as a "bump." Most that have it never have pain. If they get pain, we call it: "Accessary navicular bone syndrome."



Causes
The syndrome may result from any of the following, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against the bone. Strain from overuse or excessive activity.

Symptoms
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.

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
Initial treatment is conservative. With the first episode of symptoms, a medial heel wedge, anti-inflammatories, and physical therapy can be helpful. If very painful, a cast or boot may be needed for a short period time before the wedge and physical therapy can be initiated. Very rarely is a steroid injection warranted or recommended. As the pain improves, patients can resume activities. For a minority of patients, an arch support or custom orthotic can help to take some of the extra pressure off of the accessory navicular and the posterior tibial tendon.



Surgical Treatment
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.