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Foot Accessory Navicular Excision


Overview
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. This can result from any of the following, trauma, as in a foot or ankle sprain, chronic irritation from shoes or other footwear rubbing against the extra bone. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.

Accessory Navicular

Causes
Just having an accessory navicular bone is not necessarily a bad thing. Not all people with these accessory bones have symptoms. Symptoms arise when the accessory navicular is overly large or when an injury disrupts the fibrous tissue between the navicular and the accessory navicular. A very large accessory navicular Can better posture make you taller? cause a bump on the instep that rubs on your shoe causing pain.

Symptoms
The primary reason an accessory navicular becomes a problem is pain. There is no need to do anything with an accessory navicular that is not causing pain. The pain is usually at the instep area and can be pinpointed over the small bump in the instep. Walking can be painful when the problem is aggravated. As stated earlier, the condition is more common in girls. The problem commonly becomes symptomatic in the teenage years.

Diagnosis
Accessory navicular syndrome is diagnosed by asking about symptoms and examining the foot for skin irritation and swelling. Doctors may assess the area for discomfort by pressing on the bony prominence. Foot structure, muscle strength, joint motion and walking patterns may also be evaluated.

Non Surgical Treatment
Using PRP treatments, orthotics, proper running shoes and physical therapy should do the trick. No long recovery, no long down time. My runners and athletes are usually back to their sport pain free within a month. The key is eliminating the syndrome, not the bone (or cartilage).

Accessory Navicular Syndrome

Surgical Treatment
Fusion of the accessory navicular to the navicular with screws is required when there is a large accessory navicular bone and removal of this bone would reduce the articular surface of the Navicular to the talus (coxa pedis). Fusion will relieve pain without disrupting the tibialis posterior tendon insertion nor narrowing talar head support. In most instances, a patient’s recovery will be as follows. 0-6 weeks: Immobilization (in case or cast boot) non-weight-bearing or touch weight-bearing. 6-10 weeks: Increasing activity in a cast boot. Physical therapy to work on strength and balance. Full recovery after 9 weeks-2 months. In some patients (where the posterior tibial tendon is still intact and functioning) the treating surgeon may allow weight-bearing as tolerated in a cast boot immediately after surgery.

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برچسب: How do you prevent Achilles tendonitis?، What do you do when your Achilles tendon hurts?، How did the Achilles tendon get it's name?،
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Physical Therapy Exercises For Accessory Navicular Syndrome


Overview
Sometimes, feet do weird things. For instance, about 10% of the general population?s feet have decided that having an extra bone in the mix is a really great idea. This extra bone (or sometimes a bit of cartilage), is called an accessory navicular. It shows up in a tendon called the posterior tibial tendon (which is a fancy name - but just remember, it helps support the arch of the foot) on the middle of the inside of the foot, just above the arch. This extra little bone is present from birth, so it?s not something that?ll suddenly grow later in life. Now, accessory navicular syndrome is when that extra bone starts causing issues with your shoe-wearing, or even the shape and function of your foot. It?s the syndrome you want to worry about, not necessarily the extra bone itself.

Accessory Navicular

Causes
Most of the time, this condition is asymptomatic and people may live their whole lives unaware that they even have this extra bone. The main reason the accessory navicular bone becomes problematic is when pain occurs. There is no need for intervention if there is no pain. The accessory navicular bone is easily felt in the medial arch because it forms a bony prominence there. Pain may occur if the accessory bone is overly large causing this bump on the instep to rub against footwear.

Symptoms
What makes you grow taller during puberty? precipitates the pain? It will usually be caused by rubbing of the skate or other footwear against the prominence. You?ll commonly see blisters or a red irritated area. Other symptoms to look for, especially when you?re treating an older child or adult, include an area of pain along the posterior tibial tendon of the arch and fatigue of the legs. Typically, these patients are not able to participate in sports for a lengthy period of time or you?ll hear them complain of pain and/or soreness after extended activities. Most individuals with a prominent navicular area will have tried accommodating this area with a doughnut pad or adjustments to their skate.

Diagnosis
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or s welling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated. X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluate the condition.

Non Surgical Treatment
Patients with a painful accessory navicular 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 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 pain to subside. Treatments directed to the painful area help control pain and swelling. Examples include ultrasound, moist heat, and soft-tissue masغير مجاز مي باشدe. Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area.

Accessory Navicular

Surgical Treatment
If all nonsurgical measures fail and the fragment continues to be painful, surgery may be recommended. 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 navicular. The accessory navicular is then detached from the posterior tibial tendon and removed from the foot. The posterior tibial tendon is reattached to the remaining normal navicular. 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 need to be taken out). You should be safe to be released to full activity in about six weeks.

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برچسب: What causes burning pain in Achilles tendon?، How can you get taller in a week?، How much does it cost to lengthen your legs?،
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+ نوشته شده: ۲۶ شهريور ۱۳۹۶ساعت: ۰۴:۳۰:۰۲ توسط:Siobhan O'Loughlin موضوع: