Änderungen

Overview<br>Accessary The accessory navicular is an ossicle, or extra bone syndrome affects overpronators because of irritation in this arealocated medially to the navicular. Improper fitting shoes can also irritate Depending on the area. When pain becomes such that it changes running form type, or becomes intolerablestage, something needs it may be connected to be donethe navicular by a fibrous union, via a type of joint called a synchrondrosis. Surgery alone without addressing causative factors In those who have this extra bone, it is uselesspresent at birth, but it starts as soft cartilage and then begins to ossify (turn into bone) at around age nine. Pain returns and new cartilage returns Some sources believe that, in about half of those who have it, the bone will fuse to the tendonnavicular in late adolescence, and the inflammation causes painbut it is not clear that this actually happens.<br><br><br><br>Causes<br>Most It is commonly believed that the posterior tibial tendon loses its vector of pull to heighten the timearch. As the posterior muscle contracts, this condition the tendon is asymptomatic and people may live their whole lives unaware that they even have this extra bone. The main reason no longer pulling straight up on the accessory navicular but must course around the prominence of bone becomes problematic is when pain occursand first pull medially before pulling upward. There is no need for intervention if there is no pain. The accessory navicular bone is easily felt in In addition, the enlarged bones may irritate and damage the insertional area of the medial arch because posterior tibial tendon, making it forms a bony prominence thereless functional. Pain may occur if Therefore, the presence of the accessory navicular bone is overly large causing this bump on the instep does contribute to rub against footwearposterior tibial dysfunction.<br><br>Symptoms<br>Most people born with Symptoms of this syndrome would include redness, swelling and tenderness over the navicular bone begin to experience the symptoms (if at all any) in adolescence. Some may not develop any symptoms until adulthood. The symptoms are a visible abnormal protrusion in navicular bone is located on the inside of the mid-footapproximately midway between the ankle bone and big toe joint. It will tend to be worse after activity and can be aggravated by those that wear very dressy shoes as opposed to casual shoes like sneakers. In other words, swelling and redness of the protrusionflatter or less supportive the shoe, the greater the chance for pain in the mid-foot after performing an activity.<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://PlazaIsadorakraemer.rakutenblog.cofc2.jpcom/vernacorkum/diary/201507110000 blog-entry-34.html heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The goal of non-surgical treatment for a symptomatic accessory navicular can syndrome is to relieve the symptoms. The following may be divided into nonsurgical treatment used. Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and surgical treatmentdecreases the inflammation. Ice. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. In Do not put ice directly on the vast majority of casesskin. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), treatment usually begins with nonsurgical measures such as orthoticsibuprofen, may be prescribed. In some cases, strappings oral or bracinginjected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Surgery usually is only considered when all nonsurgical measures have failed Physical therapy may be prescribed, including exercises and treatments to control your problem 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 pain becomes intolerablesymptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.<br><br><br><br>Surgical Treatment<br>If non-surgical treatment fails all nonsurgical measures fail and the fragment continues to relieve the symptoms of accessory navicular syndromebe painful, surgery may be appropriaterecommended. Surgery may involve removing The most common procedure used to treat the symptomatic accessory navicular is the Kidner procedure. A small incision is made in the instep of the foot over the accessory bone, reshaping navicular. The accessory navicular is then detached from the area, posterior tibial tendon and repairing removed from the foot. The posterior tibial tendon is reattached to improve its functionthe remaining normal navicular. This extra bone Following the procedure, the skin incision is closed with stitches, and a bulky bandage and splint are applied to the foot and ankle. You may need to use crutches for several days after surgery. Your stitches will be removed in 10 to 14 days (unless they are the absorbable type, which will not needed for normal foot functionneed to be taken out). You should be safe to be released to full activity in about six weeks.