An accessory navicular bone is an accessory bone of the foot that occasionally develops abnormally in front of the ankle towards the inside of the foot. This bone may be present in approximately 2-14% of the general population and is usually asymptomatic. When it is symptomatic, surgery may be necessary. Surgery How can we increase our height? be performed at any age because it does not alter any other bones.
People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse.
This painful condition is called accessory navicular syndrome. Accessory navicular syndrome (ANS) can cause significant pain in the mid-foot and arch, especially with activity. Redness and swelling may develop over this bony prominence, as well as extreme sensitivity to pressure. Sometimes people may be unable to wear shoes because the area is too sensitive.
Upon examining a foot with a symptomatic accessory navicular, there will often be a bony prominence on the inside of the foot, just below and in front of the inside ankle bone (medial malleolus). The size of this prominence will vary from small to quite large. Pressing over this area will often cause discomfort. There may be an associated flat foot deformity as this can occur in patients with an accessory navicular. Stressing the posterior tibial tendon by raising the heel up and down on one foot, or by forcing the foot to the inside against resistance, may aggravate the symptoms as these maneuvers stress the posterior tibial tendon which is attached on the inside of the accessory navicular bone. Patients may walk with a slight limp due to the pain.
Non Surgical Treatment
Although operative treatment, and removal of the accessory navicular is possible, this is not usually indicated at first. Conservative nonoperative treatment is best, the course depending on the severity of the symptoms. When the pain is very severe, which could indicate a fracture, a period of immobilization might be required. This is done by waring a fracture boot, or a cast, which can help the ossicle stay stable, aiding in healing. Immobilization usually lasts between 4 to 6 weeks. Afterwards, physical therapy exercise, or any appropriate home course, should be used to help strengthen the ankle and return the ankle and foot to full range of motion, and have no pain on movement. Sometimes crutches are used when weight bearing is too painful, but it is best to try to bear weight when possible.
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.
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