An accessory navicular is an extra bone fragment or piece of cartilage material in the arch of the foot that may or might not produce issues. It is also called an os navicularum or os tibiale externum. It is incorporated within the tendon of the posterior tibial muscle that inserts in the region. The excess bone is on the inside side of the navicular bone which is the bone that is near the top of the mid-foot of the feet. It takes place in from 5-15% of the population. It's not usually a problem, however the prominence of the accessory bone could make stress from the shoes painful. At times the bone is in such a location that it can change the angle of action of the posterior tibial muscle which generally affect foot function and will cause any number of biomechanical problems, for instance a flat foot.
The verification is usually by x-ray in which the existence of the extra bone is obvious. There are lots of types which the x-ray might help establish which one it is. The Geist grouping separates the accessory navicular bones into 3 differing types. Each one of the three kinds impacts the structure and biomechanics with the foot in different ways and each of the three differing types needs a different treatment strategy.
The aim of treatment is to relieve the signs and symptoms and prevent it being painful. When the pain is quite bad, then putting the foot in a cast or easily-removed walking boot allows the affected region to rest which helps the symptoms. Ice can also be used to reduce swelling. Oral nonsteroidal anti-inflammatory drugs (NSAIDs) may be used along with immobilization to further lessen the pain and swelling. Physical exercises and treatment options to strengthen the muscles may also be suggested, especially over the long term to help you avert a repeat in the signs and symptoms. Foot orthotic devices usually are extremely beneficial to safeguard the area and be certainly helpful when the accessory navicular is bringing about a flat foot.
The accessory navicular bone can certainly be a unique problem is sports including skiing as well as ice skating. It is because the footwear of these sports goes around the feet and it is rather stiff. So, if someone has a acessory bit of bone on the feet, just like an accessory navicular, this is often really painful and also not easy to handle. Things like donut type pads to deflect the pressure coming from the footwear away from the area is often useful. This is also where the expertise of a boot maker or a proficient ski boot fitter might be invaluable. They are used to dealing with these types of troubles and can modify the footwear around the enlarged navicular to make it much more comfortable. A podiatric doctor can often assist with all this.
When the traditional nonsurgical therapies tend not to get rid of the signs and symptoms, then surgery might be indicated. Surgery may require removing the extra bone, re-shaping the region and reconstructing the posterior tibial tendon for increasing its biomechanics. This accessory bone isn't really necessary for normal foot biomechanics, therefore theoretically it won't be missed.