The accessory navicular also termed How did the Achilles tendon get it's name? os navicularum or os tibiale externum - is an extra bone or piece of cartilage on the inner side of the foot above the arch that attaches to the posterior tibial tendon within this area. This extra bone, present at birth, is not part of the normal bone structure and found in approximately 10% of the population. Some people with an accessory navicular may be unaware of the condition if symptoms are never experienced. But accessory navicular syndrome is a painful condition caused by aggravating the bone, the posterior tibial tendon or both.Accessory navicular syndrome is an irritation of the accessory navicular and/or posterior tibial tendon. This irritation can be caused by shoe rubbing, trauma, excessive activity, or overuse and can cause problems with the shape and function of your foot. Many people with this disorder also have flat feet which puts more strain on the posterior tibial tendon. Some people are born with an accessory Navicular because during development, the bones of the feet sometimes develop abnormally causing the extra bone to form on the inside of the foot.
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.
Symptoms of accessory navicular syndrome often appear in adolescence, when bones are maturing. Symptoms include A visible bony prominence on the midfoot, Redness and swelling, Vague pain or throbbing in the arch, especially after physical activity.
Your doctor will diagnose an accessory navicular by examining your child?s foot. Your physician may also obtain x-rays to confirm the accessory navicular and to rule out other conditions.
Non Surgical Treatment
The foot may be placed in a cast or removable walking boot to allow the affected area to rest and decrease the inflammation. Physical therapy including exercises and treatments to strengthen the muscles, decrease inflammation, and prevent recurrence of the symptoms. Custom orthopedic devices that fit into the shoe providing arch support. Even after successful treatment, symptoms may reappear.
Surgery may be an option if non-surgical treatment does not decrease the symptoms of accessory navicular syndrome. Since this bone is not needed for the foot to function normally, Your surgeon may remove the accessory navicular, reshape the area, and repair the posterior tibial tendon for improved function.
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