The navicular bone of the foot is one of the small bones on the mid-foot. The bone is located at the instep, the arch at the middle of the foot. One of the larger tendons of the foot, called the posterior tibial tendon, attaches to the navicular before continuing under the foot and into the forefoot. This tendon is a tough band of tissue that helps hold up the arch of the foot. If there is an accessory navicular, it is located in the instep where the posterior tibial tendon attaches to the real navicular bone.
An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.
The main symptom of an aggravated accessory navicular is pain, particularly in the instep. Walking can sometimes be difficult, and tight shoes may worsen the condition.
Your podiatrist will most likely diagnose accessory navicular syndrome by making a visual study of the area, checking whether the shape of your foot and your ability to move it indicate there?s an accessory navicular lurking around. He or she may push on the prominence on your foot to check to see if it hurts, and may ask you to walk around in order to ascertain How much does it غير مجاز مي باشدt to lengthen your legs? your gait is affected. In order to get a certain diagnosis, your podiatrist will need some way to see the inside of your foot, which will most likely involve getting X-rays, or possibly an MRI or some other scan of your foot?s interior.
Non Surgical Treatment
Treatment options for a painful accessory navicular can include anti-inflammatory medications, rest, arch support structures in the shoe, or use of a cast or splint. Severe cases may require surgery.
After the anesthesia is administered you will be heavily sedated and placed on your stomach. Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot. The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed. Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed. A splint will be placed on the foot for stabilization and immobilization. You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist. Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication. Use narcotic pain medications before bed or if numbness in your foot begins to dull. Schedule a post-op visit for 4 weeks after the procedure.
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