The accessory navicular is an extra bone or piece of cartilage material within the arch of the foot that may or may not result in problems. Also, it is often known as an os navicularum or os tibiale externum. It is integrated inside the tendon of the posterior tibial muscle which attaches in the area. The excess bone is on the inside side of the navicular bone that is the bone which is towards the top of the mid-foot of the foot. It happens in from 5-15% of the population. It is not usually a problem, however the prominence of the bone might make force from the footwear painful. Sometimes the accessory bone is in such a position which it may change the angle of pull of the posterior tibial muscle which generally affect foot functionality and can induce several dysfunctional problems, like a flat foot.
The verification is commonly by x-ray where the existence of the accessory bone is pretty obvious. There are several varieties which the x-ray will help figure out what type it is. The Geist grouping breaks the accessory navicular bones into three different types. Each of the 3 varieties has an effect on the structure and biomechanics in the feet in a different way and each of the 3 different types requires a distinct therapy method.
The objective of treatment solutions are to alleviate the symptoms preventing it getting painful. In the event the pain is especially bad, then placing the foot within a cast or easily-removed walking boot will permit the affected region to rest and help the pain. Ice could also be used to reduce swelling. By mouth nonsteroidal anti-inflammatory drugs (NSAIDs) can be utilized along with immobilization to help lower the pain and inflammation. Exercises and treatments to strengthen the muscles can also be encouraged, particularly in the long run to help avoid a recurrence in the signs and symptoms. Foot orthotic inserts are extremely beneficial to safeguard the area and become certainly helpful in the event the accessory navicular is causing a flat foot.
The accessory navicular may be a unique concern is sports such as skiing and also ice skating. It is because the boots in these sports activities goes around the feet and its very rigid. So, if anyone has a enlarged area of bone on the feet, such as an accessory navicular, this may be quite painful and in addition difficult to manage. Things like doughnut type padding to get the force coming from the shoes away from the spot is frequently helpful. This is also where the proficiency of a boot maker or a proficient ski boot fitter will be important. They are used to addressing these kinds of complications and can modify the footwear around the enlarged navicular to make it more at ease. A podiatric doctor can often assist with all of this.
When the conservative nonsurgical treatments do not reduce the pain, then surgery may be appropriate. Surgery may involve removing the additional bone, reshaping the spot and correcting the posterior tibial tendon to improve its biomechanics. This accessory bone just isn't necessary for normal foot function, thus in theory it will not be a problem.