What Is Accessory Navicular Syndrome: Unterschied zwischen den Versionen

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Overview<br>The accessory navicular is an extra piece of cartilage or bone on the inner side of the foot. It is found in about 10 percent of individuals and is present at birth. Many people who have an accessory navicular are never aware of it because they do not experience symptoms. However, aggravation of the accessory navicular or the posterior tibia tendon, which it is attached to, can develop as a result of trauma, irritation from shoes, and excessive overuse.<br><br><br><br>Causes<br>Accessory navicular syndrome as it is called can result from a number of causes, excess or overuse syndrome as seen in an athlete. Trauma to the foot as in an ankle sprain or direct trauma to the navicular bone. chronic irritation from shoes rubbing against the extra bone, over time, may cause pain. Excessive pronation which strains the attachment of tibialis posterior muscles into the navicular bone. Keep in mind, the larger the actual accessory bone, the greater the chance of it becoming an issue.<br><br>Symptoms<br>The majority of people with an accessory navicular experience no symptoms, since, for the most part, the little extra bone simply isn?t large enough to cause problems. Unfortunately, some people lose on ?accessory navicular roulette,? and the bone begins to mess things up with the foot. These problems usually show up sometime in adolescence, when bones and cartilage in the body are settling into their final shapes (although occasionally people make it all the way through childhood, only to start experiencing discomfort and pain in adulthood).<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://ickyprogression13.Hazblog.com heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The treatment for a symptomatic accessory navicular can be divided into nonsurgical treatment and surgical treatment. In the vast majority of cases, treatment usually begins with nonsurgical measures such as orthotics, strappings or bracing. Surgery usually is only considered when all nonsurgical measures have failed to control your problem and the pain becomes intolerable.<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>In an ideal situation, the navicular bone and the accessory bone will fuse together to form one bone. The problem that occurs is that sometimes the two bones do not fuse together and the patient is left with what is known as a fibrous union or basically a non solid union of bone to bone. This fibrous union is more like scar tissue and in theory can cause pain when excessive strain is placed upon it.<br><br><br><br>Causes<br>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.<br><br>Symptoms<br>Most people with an accessory navicular do not have symptoms because the bone is so small that it causes no harm, or only develop symptoms after a trauma such as a break or sprain. When symptoms are present they could be a visible bony prominence, pain and throbbing, inflammation and redness, and flat feet.<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://nostalgicdepict29.sosblogs.com heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.<br><br><br><br>Surgical Treatment<br>If non-operative treatment fails to relieve the patient’s symptoms, surgical intervention may be warranted. The standard operative treatment of an accessory navicular is a Kidner procedure.  However, if surgery is undertaken it is important that it address the underlying source of the patients pain.

Version vom 13. Juni 2017, 15:39 Uhr

Overview
In an ideal situation, the navicular bone and the accessory bone will fuse together to form one bone. The problem that occurs is that sometimes the two bones do not fuse together and the patient is left with what is known as a fibrous union or basically a non solid union of bone to bone. This fibrous union is more like scar tissue and in theory can cause pain when excessive strain is placed upon it.



Causes
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.

Symptoms
Most people with an accessory navicular do not have symptoms because the bone is so small that it causes no harm, or only develop symptoms after a trauma such as a break or sprain. When symptoms are present they could be a visible bony prominence, pain and throbbing, inflammation and redness, and flat feet.

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
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.



Surgical Treatment
If non-operative treatment fails to relieve the patient’s symptoms, surgical intervention may be warranted. The standard operative treatment of an accessory navicular is a Kidner procedure. However, if surgery is undertaken it is important that it address the underlying source of the patients pain.

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