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Overview<br>The he accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of sideof the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people. What is Accessory Navicular Syndrome? People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated.<br><br><br><br>Causes<br>Accessory navicular syndrome as it is called can result from a number Most of causesthe time, excess or overuse syndrome as seen in an athletethis condition is asymptomatic and people may live their whole lives unaware that they even have this extra bone. Trauma to the foot as in an ankle sprain or direct trauma to The main reason the accessory navicular bonebecomes problematic is when pain occurs. chronic irritation from shoes rubbing against the extra bone, over time, may cause There is no need for intervention if there is no pain. Excessive pronation which strains the attachment of tibialis posterior muscles into the The accessory navicular bone. Keep is easily felt in mind, the larger medial arch because it forms a bony prominence there. Pain may occur if the actual accessory bone, is overly large causing this bump on the greater the chance of it becoming an issueinstep to rub against footwear.<br><br>Symptoms<br>It?s Perhaps the most common for any symptoms to present during adolescence, when of the extra bones are maturingin the foot, though problems may not occur until adulthood. You may notice a bony prominence on the inner side accessory navicular bone is estimated to be present in 7 to 19 percent of the midfootpopulation. There may or may not be redness Zadek and swelling around this bumpGold maintained that the bone persisted as a distinct, especially if it rubs against footwearseparate bone in 2 percent of the population. You may Also be prone to blisters or sores in aware that the area. Pain generally involves a vague ache accessory bone normally fuses completely or throbbing in incompletely to the midfoot and arch as well, especially when you?re activenavicular. Many people with It is this syndrome develop flat feetincomplete fusion which allows for micromotion, which, tooin turn, which may cause degenerative changes that can create additional strain in also contribute to the footpain.<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://jaymeteeheedeneseleider.jimdohatenablog.com/entries/2015/06/27/hammer-toe-causes-pain heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The treatment for Patients with a symptomatic painful accessory navicular can may benefit with four to six physical therapy treatments. Your therapist may design a series of stretching exercises to try and ease tension on the posterior tibial tendon. A shoe insert, or orthotic, may be divided into nonsurgical treatment used to support the arch and protect the sore area. This approach may allow you to resume normal walking immediately, but you should probably cut back on more vigorous activities for several weeks to allow the inflammation and surgical treatmentpain to subside. In Treatments directed to the vast majority of casespainful area help control pain and swelling. Examples include ultrasound, treatment usually begins with nonsurgical measures such as orthoticsmoist heat, strappings or bracingand soft-tissue massage. Surgery usually is only considered when all nonsurgical measures have failed Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to control your problem and the pain becomes intolerablesore area.<br><br><br><br>Surgical Treatment<br>In the The original procedure advocated by Kidner procedure, involved shelling out of the accessory navicular bone from within the insertional area of the entire posterior tibial tendon was released from the navicular and then rerouted through a drill hole placed through rerouting this tendon under the navicular. The original Kidner procedure is now rarely used as bone in hopes of restoring a means normal pull of this tendon. When treating an isolated accessory navicular. Insteadyounger children, a modification of the Kidner procedure history has become more commonplace. The modified Kidner procedure consists shown us that simply shelling out of carefully removing the accessory and anchoring navicular bone from within the posterior tibial tendon to and remodeling the surface tuberosity of the navicular where bone can give you satisfactory results.<br>In general, you want to reserve advancement of the accessory was removedposterior tibial tendon for adults or those who have a more significant flatfoot deformity. The repair You may be done by passing a suture through the tendon and then through drill holes also use this approach after determining that quality custom orthotics are only resulting in the navicular, or by using a suture anchorslight decrease of symptoms.