Accessory navicular describes the presence of an extra bone growth center on the inside of the navicular and within the posterial tibial tendon that attaches to the navicular. The primary symptom from this additional bony prominence is pain and tenderness. This congenital defect (present at birth) is thought to occur during development when the bone is calcifying. Because this accessory portion of the bone and the navicular never quite grow together, it is believed that, over time, the excessive motion between the two bones results in pain.
What causes pain in the back of the heel?
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.
The primary reason an accessory navicular becomes a problem is pain. There is no need to do 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.
The diagnosis begins with a complete history and physical examination by your surgeon. Usually the condition is suggested by the history and the tenderness over the area of the navicular. X-rays will usually be required to allow the surgeon see the accessory navicular. Generally no other tests are required.
Non Surgical Treatment
The initial treatment approach for accessory navicular is non-operative. An orthotic may be recommended or the patient may undergo a brief period of casting to rest the foot. For chronic pain, however, the orthopedic surgeon removes the extra bone, a relatively simple surgery with a brief rehabilitation period and a very good success rate.
Once the navicular inflammation has lessened it is not necessary to perform surgery unless the foot becomes progressively flatter or continues to be painful. For these children, surgery can completely correct the problem by removing the accessory navicular bone and tightening up the posterior tibial tendon that attaches to the navicular bone. The strength of this tendon is integral to the success of this surgery as well as the arch of the foot. Following surgery the child is able to begin walking on the foot (in a cast) at approximately two weeks. The cast is worn for an additional four weeks. A small soft ankle support brace is then put into the shoe and worn with activities and exercise for a further two months.
برچسب: What do you do for a strained Achilles tendon?، What do you do for a strained Achilles tendon?، Can you get an operation to make you taller?،
+ نوشته شده: ۳ شهريور ۱۳۹۶ساعت: ۰۱:۵۳:۳۲ توسط:Elma Streeton موضوع: