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The Accessory Navicular Bone

Date Added: October 22, 2015 03:06:35 AM
Author:
Category: Orthopedics: Accessory Bones

 

The accessory navicular is an additional piece of bone on the inside of the foot pretty much on top of the mid-foot ( arch ) near its highest point. The bone is incorporated within the tibialis posterior tendon that inserts into the navicular bone towards the top of the mid-foot ( arch ). The additional bone may also be called the os navicularum or os tibiale externum. It is hereditary, so is present since birth. There are various varieties of accessory navicular and the Geist classification is most typically used. This typology separates the accessory navicular into 3 variations:
Type 1 accessory navicular bone:
This is the classical ‘os tibiale externum’ and make up to 30% of the cases; it's a 2-3mm sesamoid bone inserted within the distal area of the tendon without having any connection to the navicular tuberosity and may even be divided from it by up to 5mm
Type 2 accessory navicular bone:
This type makes up 55% of the accessory navicular bones; it is triangular or heart-shaped and linked to the navicular bone through cartilage material. It could eventually merge to the navicular to form one bone.
Type 3 accessory navicular bone:
Prominent navicular tuberosity. This could have been a Type 2 that's joined to the navicular
The usual sign associated with an accessory navicular is the enlargement on the medial side of the mid-foot ( arch ). Because of the extra bone there, this has an effect on how well the arch muscles function and might result in a painful foot. Inflexible type shoes, such a ice skates, may also be quite uncomfortable to wear because of the enlarged prominent bone.
The therapy will be aimed towards the symptoms. If the flatfoot is a concern, then ice, immobilisation and also pain relief drugs may be required to begin with. Next, physical therapy and foot orthotic devices to aid the foot are used. If the pain is because of pressure from the style of footwear which needs to be used, then donut type padding is required to get pressure off the sore area or the shoes may need to be customized.
If these non-surgical therapies fail to eliminate the symptoms of the accessory navicular or perhaps the problem is a continuing one, then surgery might be an appropriate option. This requires detaching the accessory bone and fixing the attachment of the tibialis posterior tendon so its function is enhanced.

The accessory navicular is an additional piece of bone on the inside of the foot pretty much on top of the mid-foot ( arch ) near its highest point. The bone is incorporated within the tibialis posterior tendon that inserts into the navicular bone towards the top of the mid-foot ( arch ). The additional bone may also be called the os navicularum or os tibiale externum. It is hereditary, so is present since birth. There are various varieties of accessory navicular and the Geist classification is most typically used. This typology separates the accessory navicular into 3 variations:

Type 1 accessory navicular bone:
This is the classical ‘os tibiale externum’ and make up to 30% of the cases; it's a 2-3mm sesamoid bone inserted within the distal area of the tendon without having any connection to the navicular tuberosity and may even be divided from it by up to 5mm

Type 2 accessory navicular bone:
This type makes up 55% of the accessory navicular bones; it is triangular or heart-shaped and linked to the navicular bone through cartilage material. It could eventually merge to the navicular to form one bone.

Type 3 accessory navicular bone:
Prominent navicular tuberosity. This could have previously been a Type 2 that's joined to the navicular

The usual sign associated with an accessory navicular is the enlargement on the medial side of the mid-foot ( arch ). Because of the extra bone there, this has an effect on how well the arch muscles function and might result in a painful foot. Inflexible type shoes, such a ice skates, may also be quite uncomfortable to wear because of the enlarged prominent bone.

The therapy will be aimed towards the symptoms. If the flatfoot is a concern, then ice, immobilisation and also pain relief drugs may be required to begin with. Next, physical therapy and foot orthotic devices to aid the foot are used. If the pain is because of pressure from the style of footwear which needs to be used, then donut type padding is required to get pressure off the sore area or the shoes may need to be customized.

If these non-surgical therapies fail to eliminate the symptoms of the accessory navicular or perhaps the problem is a continuing one, then surgery might be an appropriate option. This requires detaching the accessory bone and fixing the attachment of the tibialis posterior tendon so its function is enhanced.

 

 

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