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Overview<br>The There are three different types of accessory navicular . This extra cartilage, which is turned into bone , is located on found attached to the top of posterior tibial tendon, just medial (inside) the foot near the arch. People who have this extra navicular bone can feel a bump or bony protuberance on the top of the foot above the arch. While the bone itself does not cause pain, The accessory navicular syndrome can develop when affect the bone and/or nearby tendon is irritated. The navicular bone is attached to muscles, ligaments and insertion of the posterior tibial tendon. Since ligaments This tendon has a job of keeping your foot aligned and tendons have poor blood supply helping to maintain an arch. The accessory navicular can be associated with a normal foot posture and don?t heal easilyalignment, any irritation to the surrounding structures can develop into or sometime with a painful conditionflat (pes planus) foot.<br><br><br><br>Causes<br>An injury to the fibrous tissue connecting the two bones can cause something similar to a fracture. The injury allows movement to occur between the navicular and the accessory bone and is thought to be the cause of pain. The syndrome fibrous tissue is prone to poor healing and may result from any of continue to cause pain. Because the posterior tibial tendon attaches to the followingaccessory navicular, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against it constantly pulls on the bone. Strain from overuse or excessive activity, creating even more motion between the fragments with each step.<br><br>Symptoms<br>Symptoms Possible symptoms of accessory navicular syndrome include redness or swelling in the area of the accessory navicular, and pain that is present around the middle of the foot around the arch. Discomfort is most often present following periods of exercise or prolonged walking or standing. The bone may be somewhat visible on the inside of the foot above the arch. Most symptoms of accessory navicular syndrome first appear in childhood around the time of adolescence, when as the bones are maturingstill growing and developing. Symptoms include A visible bony prominence on the midfootFor some with an accessory navicular, Redness and swellingthough, Vague pain or throbbing in the arch, especially after physical activitysymptoms may not appear until entering 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://ailenebrimchicfinal26.blogassnack.ltws/ hammer-toe-operation-complications.html heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Excess weight will increase The goal of non-surgical treatment for accessory navicular syndrome is to relieve the force on symptoms. The following may be used. Placing the posterior tibial tendon as it inserts into foot in a cast or removable walking boot allows the accessory navicular affected area to rest and will tend to precipitate or aggravate symptomsdecreases the inflammation. If To reduce swelling, a patient bag of ice covered with a symptomatic accessory navicular thin towel is overweightapplied 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, then losing weight can oral or injected steroid medications may be very helpfulused in combination with immobilization to reduce pain and inflammation. Even losing 5-10lbs will Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease the amount inflammation. The exercises may also help prevent recurrence of force going through the foot with each step by as much as 15-30lbssymptoms. This is because Custom orthotic devices that fit into the shoe provide support for the foot acts like arch, and may play a lever serving to magnify role in preventing future symptoms. Even after successful treatment, the force absorbed by the foot with each stepsymptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.<br><br><br><br>Surgical Treatment<br>If conservative measures do not seem to helpIn the original Kidner procedure, howeverthe entire posterior tibial tendon was released from the navicular and then rerouted through a drill hole placed through the navicular. The original Kidner procedure is now rarely used as a means of treating an isolated accessory navicular. Instead, you may need to have surgery to make adjustments to a modification of the bumpKidner procedure has become more commonplace. This could include reshaping The modified Kidner procedure consists of carefully removing the little bone, repairing damage to accessory and anchoring the posterior tibial tendon, or even removing to the surface of the navicular where the accessory was removed. The repair may be done by passing a suture through the tendon and then through drill holes in the navicular altogether, or by using a suture anchor.