Removal Of Accessory Navicular Bone Recovery

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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.



Causes
This painful foot condition is caused by an extra bone in the foot called the accessory navicular. Only about 10% of people have this bone (4 to 21%), and not all of them will develop any symptoms. The navicular bone is one of the normal tarsal bones of the foot. It is located on the inside of the foot, at the arch.

Symptoms
Symptoms of this syndrome would include redness, swelling and tenderness over the navicular bone. The navicular bone is located on the inside of the foot approximately midway between the ankle bone and big toe joint. It will tend to be worse after activity and can be aggravated by those that wear very dressy shoes as opposed to casual shoes like sneakers. In other words, the flatter or less supportive the shoe, the greater the chance for 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
For less severe symptoms, decreasing or modifying activity, such as avoiding aggravating activities, may suffice. Ice and NSAIDS can be used to help control pain. An arch support or an orthotics may help to stabilize the arch during this time. When rubbing on the bump causes pain, a doughnut pad can be worn. Exercises to increase range of motion and improve movement should still be used.



Surgical Treatment
Surgery may be an option if non-surgical treatment does not decrease the symptoms of accessory navicular syndrome. Since this bone is not needed for the foot to function normally, Your surgeon may remove the accessory navicular, reshape the area, and repair the posterior tibial tendon for improved function.