Änderungen

Overview<br>The bones of the foot occasionally develop abnormally in a child and In an extra bone called an accessory navicular is present towards the inside of the footideal situation, in front of the ankle. This navicular bone is present in approximately 10% of and the general population but not large enough accessory bone will fuse together to cause symptoms in the majority of these individualsform one bone. The extra bone lump present in childhood can be quite uncomfortable because it rubs on shoes. In addition, problem that occurs is that sometimes the two bones do not fuse together and the feet associated patient is left with the accessory navicular are invariably flat. If the child what is active and involved in various athletic activities, this will aggravate the inflammation known as a fibrous union or basically a non solid union of the tendon that attaches bone to the accessory navicularbone. This tendon fibrous union is called the posterior tibial tendon more like scar tissue and in theory can cause pain when excessive strain is responsible for maintaining the strength of the arch of the foot. The flat-footedness associated with the accessory navicular usually brings the child for treatmentplaced upon it.<br><br><br><br>Causes<br>Just having an accessory navicular bone It is not necessarily a bad thingcommonly believed that the posterior tibial tendon loses its vector of pull to heighten the arch. Not all people with these accessory bones have symptoms. Symptoms arise when As the posterior muscle contracts, the tendon is no longer pulling straight up on the accessory navicular is overly large or when an injury disrupts but must course around the fibrous tissue between prominence of bone and first pull medially before pulling upward. In addition, the navicular enlarged bones may irritate and damage the accessory navicularinsertional area of the posterior tibial tendon, making it less functional. A very large Therefore, the presence of the accessory navicular can cause a bump on the instep that rubs on your shoe causing painbone does contribute to posterior tibial dysfunction.<br><br>Symptoms<br>Symptoms A visible bony lump on the inner part of the foot, towards the middle, just above the arch of the foot. Redness, swelling, and sensitivity of the bony prominence. Pain or throbbing in the middle of the foot and the arch. Difficulty with foot movement and activity. Possible skin callous or skin irritation caused by footwear rubbing over the lump. Not everyone who has an accessory navicular includewill develop these problems. When problems do occur, they may begin in early adolescence. Bone lump The obvious indication is a painful bump on the inside of the foot, which hurts to touch, and causes problems that gradually become worse, and which are aggravated by activity, walking, etc. Redness and swelling, leading to all the problems discussed here. Painmay be worse towards the end of the day, and continue into the night.<br><br>Diagnosis<br>To diagnose Keep in mind there are two different types of accessory navicular syndromebones, medical staff ask about the patient?s activities and symptoms. They will examine which you can distinguish by getting a weightbearing AP X-ray of the foot for irritation or swelling. Medical staff evaluate the bone structure, muscle, joint motionDwight has classified type I as a small, round and discreet accessory bone just proximal to the patient?s gaitmain navicular bone. X-rays can usually confirm Geist described 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 type II accessory bone irritation can lead to bunions, [http://Fletcherklmmrvwfpe.Hazblog.com/ heel spurs] and plantar fasciitis, it?s important which is closely related to seek treatmentthe body of the navicular but separated by an irregular plate of dense fibro-cartilage.<br><br>Non Surgical Treatment<br>The initial goal of non-surgical treatment approach for accessory navicular syndrome is non-operativeto relieve the symptoms. An orthotic The following may be recommended used. Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the patient may undergo inflammation. Ice. To reduce swelling, a brief period bag of casting ice covered with a thin towel is applied to rest the footaffected area. Do not put ice directly on the skin. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. For chronic In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce painand inflammation. Physical therapy. Physical therapy may be prescribed, however, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Orthotic devices. Custom orthotic devices that fit into the orthopedic surgeon removes shoe provide support for the extra bonearch, a relatively simple surgery with a brief rehabilitation period and may play a very good success raterole 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>The above non-surgical options should be enough Fusion of the accessory navicular to treat the navicular with screws is required when there is a large accessory navicular syndrome. If they fail, a surgery bone and removal of this bone would be necessary reduce the articular surface of the Navicular to remove the extra bone that has been causing talus (coxa pedis). Fusion will [http://etsukosinrich.wordpress.com/ relieve pain] without disrupting the problemstibialis posterior tendon insertion nor narrowing talar head support. The In most common procedure for this condition is known instances, a patient’s recovery will be as the Kidner procedure where follows. 0-6 weeks: Immobilization (in case or cast boot) non-weight-bearing or touch weight-bearing. 6-10 weeks: Increasing activity in a small incision is made over the navicular bonecast boot. The accessory navicular is identified Physical therapy to work on strength and dissected free from balance. Full recovery after 9 weeks-2 months. In some patients (where the posterior tibial tendon. The posterior tibial tendon is then reattached to still intact and functioning) the remaining navicular bonetreating surgeon may allow weight-bearing as tolerated in a cast boot immediately after surgery.