Änderungen

Overview<br>The For most people with an accessory navicular , the extra bone is located on the top does not cause any problems and most are unaware of its presence. But certain activities or circumstances may cause the foot near the arch. People who have this extra bone can feel a bump or bony protuberance on the top of the foot above the archtibialis posterior tendon that contains it to grow irritated. While the bone itself does not cause pain, This is called accessory navicular syndrome can develop when , and its possible causes include sprains, overuse, or wearing shoes that constantly rub against the bone and/or nearby tendon is irritated. The Individuals who have a collapsed arch (commonly known as flat feet) may be at greater risk of accessory navicular syndrome, assuming they have the extra bone is attached to muscles, ligaments and because of the added daily trauma placed on the tibialis posterior tibial tendon. Since ligaments and tendons have poor blood supply and don?t heal easily, any irritation to the surrounding structures can develop into a painful condition.<br><br><br><br>Causes<br>Most Let us see the reasons why the tendon or the bone would get aggravated. Ankle or foot sprain, irritation of the timebone caused by footwear, overusing the foot, this condition is asymptomatic quite common in athletes and people may live their whole lives unaware that they even have dancers. People born with this extra bone. The main reason the accessory navicular bone becomes problematic is when pain occurs. There is no need for intervention if there is no pain. The accessory navicular bone is easily felt in are also known develop flat feet which also adds to the medial arch because it forms a bony prominence there. Pain may occur if the accessory bone is overly large causing this bump strain on the instep posterior tibial tendon and lead to rub against footwearthe syndrome.<br><br>Symptoms<br>Many people have Symptoms of accessory (?extra?) naviculars (figure 1) - a prominent extra bone extending from the navicular boneinclude. Most accessory naviculars are completely asymptomatic. However, some individuals will develop pain Bone lump on the inside of their midfoot. Pain may occur from the pressure of the shoe ware against the prominence, irritating either the bone itself or the fibrous junction where the accessory bone meets the regular navicularfoot. Alternatively, the fibrous junction or interface may become painful as a result of tension applied by the posterior tibial tendon through its connection or insertion at that siteRedness and swelling. Often, individuals will be asymptomatic for years, however, a new pair of shoes or a change in their activity level can cause symptoms. The accessory navicular itself typically develops during adolescence, when the two areas of the navicular bone fail to fuse togetherPain.<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://evasiveanyplace79earnestinerembert.exteenBlogas.com lt/ heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Excess weight will increase the force on the posterior tibial tendon as it inserts into Ideally, getting rid of the symptoms of accessory navicular syndrome will involve soothing the inflammation and will tend to precipitate or aggravate symptomsirritation in your foot. If a patient with a symptomatic accessory navicular is overweightSo, for starters, then losing weight can be very helpful. Even losing 5-10lbs will decrease your podiatrist may have you rest the amount of force going through area, allowing the foot with each step by as much as 15-30lbsinflamed tendon and bone to heal. This is because the foot acts like may be accomplished by wearing a lever serving cast or boot designed to magnify keep you from moving the force absorbed by problem area. Your podiatrist may also suggest using ice to reduce the foot with each stepswelling and inflammation, and anti-inflammatory medications (like ibuprofen, or sometimes a cortisone shot or other steroid medication).<br><br><br><br>Surgical Treatment<br>Depending upon If conservative care does not alleviate the severity the non operative or conservative treatment problem then surgical intervention should be maintained considered. The most common procedure for at least 4- 6 months before any surgical intervention. There are 2 surgeries that can be performed depending upon the this condition and symptoms. First is simple surgical excision. In this generally known as the accessory navicular along with its prominence is removed. In this Kidner procedure, skin where a small incision is made dorsally to over the prominence of accessory navicularbone. Bone is removed to the point where the medial foot has no bony prominence over the The accessory navicular, between the head of the talus and first cuneiform. Symptoms are relieved in 90% of cases. Second is Kindler procedure. In this the ossicle identified and navicular prominence is excised as in simple excision but along with dissected free from the posterior tibial tendon advancement. Posterior The posterior tibial tendon is split and advanced along the medial side of foot to provide support then reattached to longitudinal arch. After surgery 4 week short leg cast, well moulded into the arch with the foot plantigrade is applied. Partial weight bearing till the 8th week and later full weight bearing is allowed. When the cast is being removed can start building up the ROM to counter atrophy and other physical therapy treatment which include stretching and strengthening exercisesremaining navicular bone.