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Overview<br>Accessary bone syndrome affects overpronators because When there is injury to the muscle, fibrous tissue, or soft tissue of irritation in the navicular and the accessory navicular bones, symptoms will arise. This injury allows excessive movement between the bones. Fibrous tissue, ligaments and tendons have poor blood supply and are prone to poor healing. Often, this areaextra navicular bone lies near or attaches to the posterior tibial tendon. Improper fitting shoes can also irritate the area(See figure. ) When pain becomes the posterior tibial muscle contracts with movements such that it changes running form as foot inversion or becomes intolerableplantar flexion, something needs to be donethe posterior tendon moves and the accessory navicular bone moves. Surgery alone without addressing causative factors is uselessThis can cause severe pain in those with Accessory Navicular Syndrome. Pain returns and new cartilage returns in It can become disabling to patients because the posterior tibial tendonattached to the navicular bone is responsible for supporting the medial arch during standing, walking and the inflammation causes painrunning.Activities which most of us do daily!<br><br><br><br>Causes<br>It Most of the time, this condition is commonly believed asymptomatic and people may live their whole lives unaware that they even have this extra bone. The main reason the posterior tibial tendon loses its vector of pull to heighten the archaccessory navicular bone becomes problematic is when pain occurs. As the posterior muscle contracts, the tendon There is no need for intervention if there is no longer pulling straight up on the pain. The accessory navicular but must course around bone is easily felt in the medial arch because it forms a bony prominence of bone and first pull medially before pulling upwardthere. In addition, the enlarged bones Pain may irritate and damage the insertional area of the posterior tibial tendon, making it less functional. Therefore, the presence of occur if the accessory navicular bone does contribute is overly large causing this bump on the instep to posterior tibial dysfunctionrub against footwear.<br><br>Symptoms<br>Adolescence is a common time for What precipitates the pain? It will usually be caused by rubbing of the skate or other footwear against the symptoms to first appearprominence. This is You?ll commonly see blisters or a time when bones are maturing and cartilage is developing into bonered irritated area. SometimesOther symptoms to look for, howeverespecially when you?re treating an older child or adult, the symptoms do not occur until adulthood. The signs and symptoms include an area of accessory navicular syndrome include a visible bony prominence on pain along the midfoot (the inner side posterior tibial tendon of the foot, just above the arch) Redness and swelling fatigue of the bony prominencelegs. Vague Typically, these patients are not able to participate in sports for a lengthy period of time or you?ll hear them complain of pain or throbbing in the midfoot and arch, usually occurring during /or soreness after periods of activityextended activities. Most individuals with a prominent navicular area will have tried accommodating this area with a doughnut pad or adjustments to their skate.<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://zinalanzalottidrlee.blogassosblogs.ltcom/?p=9&akst_action=share-this heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Rest is the most important factor in relieving your pain. You may need to immobilize your foot to allow the affected tissues to rest enough that they can heal. Icing the area will help decrease any inflammation and swelling. Our staff may recommend anti-inflammatory medications as well. Most likely you will need to change your footwear-and possibly add orthotics-to accommodate your bony prominence and relieve strain in the midfoot. Sometimes physical therapy may be able to help strengthen tissues and prevent additional injuries.<br><br><br><br>Surgical Treatment<br>If Depending upon the severity the non-operative or conservative treatment fails to relieve should be maintained for at least 4- 6 months before any surgical intervention. There are 2 surgeries that can be performed depending upon the patient’s condition and symptoms, . First is simple surgical intervention may be warrantedexcision. In this generally the accessory navicular along with its prominence is removed. The standard operative treatment In this procedure, skin incision is made dorsally to the prominence of an accessory navicular . Bone is removed to the point where the medial foot has no bony prominence over the navicular, between the head of the talus and first cuneiform. Symptoms are relieved in 90% of cases. Second is a Kidner Kindler procedure. HoweverIn this the ossicle and 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 longitudinal arch. After surgery 4 week short leg cast, if surgery well moulded into the arch with the foot plantigrade is undertaken it applied. Partial weight bearing till the 8th week and later full weight bearing is important that it address allowed. When the underlying source of cast is being removed can start building up the patients painROM to counter atrophy and other physical therapy treatment which include stretching and strengthening exercises.