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Overview<br>Accessary An accessory navicular bone is an accessory bone syndrome affects overpronators because of irritation the foot that occasionally develops abnormally in this areafront of the ankle towards the inside of the foot. Improper fitting shoes can also irritate This bone may be present in approximately 2-14% of the areageneral population and is usually asymptomatic. When pain becomes such that it changes running form or becomes intolerableis symptomatic, something needs to surgery may be donenecessary. Surgery alone without addressing causative factors is useless. Pain returns and new cartilage returns in the tendon, and the inflammation causes paincan be performed at any age because it does not alter any other bones.<br><br><br><br>Causes<br>Most of the time, this condition is asymptomatic and people may live their whole lives unaware that they even have 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 the medial arch because it forms a bony prominence there. Pain may occur if the accessory bone is overly large causing this bump on the instep to rub against footwear.<br><br>Symptoms<br>Most people born with this bone begin to experience the symptoms This painful condition is called accessory navicular syndrome. Accessory navicular syndrome (if at all anyANS) in adolescence. Some may not develop any symptoms until adulthood. The symptoms are a visible abnormal protrusion can cause significant pain in the mid-footand arch, especially with activity. Redness and swelling and redness of the protrusionmay develop over this bony prominence, pain in as well as extreme sensitivity to pressure. Sometimes people may be unable to wear shoes because the mid-foot after performing an activityarea is too sensitive.<br><br>Diagnosis<br>To diagnose Plain x-rays are used to determine the size of the accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff There are three main types of accessory navicular bones: evaluate a small bone embedded within the nearby posterior tibial tendon; a triangular shaped bone structure, muscle, joint motion, connected to the navicular by thick cartilage; and a large prominent navicular tuberosity thought to represent an accessory navicular that has fused to the patient?s gaitnavicular. X-rays can usually confirm If the status of the diagnosis. MRI posterior tibial tendon needs to be assessed or if other imaging tests problems are suspected, (ex. Navicular stress fracture) it may be used necessary to determine any perform an MRI. Although this is not considered routine, an MRI may be helpful in identifying the degree of irritation . An MRI would demonstrate fluid or damage to soft-tissue structures such edema that may accumulate in the bone as tendons or ligaments. Because navicular accessory bone a result of the irritation can lead to bunions, [http://Plaza.rakuten.co.jp/vernacorkum/diary/201507110000 heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The treatment Aside from surgery, there are a few options for a symptomatic handling an accessory navicular bone that has become symptomatic. This includes immobilization, icing, medicating, physical therapy, and orthotic devices. Immobilizing involves placing the foot and ankle in a cast or removable walking boot. This alleviates stressors on the foot and can be divided into nonsurgical treatment decrease inflammation. Icing will help reduce swelling and surgical treatmentinflammation. In the vast majority Medication involves usage of casesnonsteroidal anti-inflammatory drugs, treatment usually begins with nonsurgical measures such as orthotics, strappings or bracingsteroids (taken orally or injected) to decrease inflammation. Surgery usually is only considered when all nonsurgical measures have failed Physical therapy can be prescribed in order to control your problem strengthen the muscles and help decrease inflammation. Physical therapy can also help prevent the symptoms from returning. Orthotic devices (arch support devices that fit in a shoe) can help prevent future symptoms. Occasionally, the orthotic device will dig into the edge of the accessory navicular and cause discomfort. For this reason, the pain becomes intolerableorthotic devices made for the patient should be carefully constructed.<br><br><br><br>Surgical Treatment<br>If Depending upon the severity the nonoperative or conservative treatment should be maintained for at least 4-6 months before any surgical treatment fails intervention. There are 2 surgeries that can be performed depending upon the condition and symptoms. First is simple surgical excision. In this generally the accessory navicular along with its prominence is removed. In this procedure, skin incision is made dorsally to relieve the symptoms prominence of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing Bone is removed to the point [http://catinaturomsha.jigsy.com/entries/general/heel-discomfort-the-causes-warning-signs-and-therapy-choices Where is the Achilles heel?] the medial foot has no bony prominence over the accessory bonenavicular, reshaping between the head of the talus and first cuneiform. Symptoms are relieved in 90% of cases. Second is Kindler procedure. In this the area, ossicle and repairing navicular prominence is excised as in simple excision but along with the posterior tibial tendon advancement. Posterior tibial tendon is split and advanced along the medial side of foot to provide support to improve its functionlongitudinal 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. This extra bone When the cast is not needed for normal foot functionbeing removed can start building up the ROM to counter atrophy and other physical therapy treatment which include stretching and strengthening exercises.<br><br>Th1s1sanart1cl3s1te