{"id":913,"date":"2021-01-13T14:10:33","date_gmt":"2021-01-13T13:10:33","guid":{"rendered":"http:\/\/cdp.net\/?page_id=913"},"modified":"2024-08-19T16:00:54","modified_gmt":"2024-08-19T14:00:54","slug":"accessory-navicular","status":"publish","type":"page","link":"https:\/\/chirurgie-du-pied.net\/en\/accessory-navicular\/","title":{"rendered":"Accessory navicular"},"content":{"rendered":"<p style=\"text-align: left;\">\n<div class=\"shadow_img_frame shadow_banner_small\"><div class=\"img-preload lightbox-img\"><a href=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/01\/os-naviculaire-acc.jpg\" class=\"attachment-fadeIn\" data-gal=\"prettyPhoto[]\" title=\"douleur au pied\"><div class=\"lightbox-zoom zoom-banner-side-nav-sidebar\" style=\"position:absolute; display: none;\">&nbsp;<\/div><img src='https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/01\/\/os-naviculaire-acc-493x201.jpg' alt='douleur au pied' class=\"attachment-fadeIn\" \/><\/a><\/div><\/div><\/p>\n<h1 style=\"text-align: justify;\">Accessory navicular<\/h1>\n<div class=\"two_thirds tt-column\"><p style=\"text-align: justify;\">An accessory navicular is an <span class=\"tooltipck\" id=\"tooltipck92734\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">extra bone<\/span><span class=\"tooltipck-tip\" style=\"width:250px;\"><span class=\"tooltipck-inner\">an \u201cextra\u201d bone compared to normal so not everyone has one.<\/span><\/span><\/span> in the foot. Most of the time, it goes unnoticed and does not need to be treated. In other cases, it can cause pain which requires treatment. This pain is often wrongly attributed to an <strong><span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/chirurgie-du-pied.net\/en\/la-cheville-pathologies-et-interventions\/ankle-sprain\/\">ankle sprain<\/a><\/span><\/strong> as it is felt near the ankle.<\/p>\n<h2><\/h2>\n<h2><strong>Anatomy and mechanism of injury<\/strong><\/h2>\n<p>In people who do not have an accessory navicular, the tibialis posterior <span class=\"tooltipck\" id=\"tooltipck92764\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">tendon<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Attaches muscle to bone.<\/span><\/span><\/span> inserts into the navicular bone. This bone is relatively large and strong so that it can tolerate the strain on the tendon.<\/p>\n<p style=\"text-align: justify;\">In people who do have an accessory navicular, there are some anatomical differences. The accessory navicular is attached to the navicular bone by a thin, fragile articulation. The tibialis posterior tendon attaches to both of these bones, covering the accessory navicular. As a result of the repeated strain on the tendon, the articulation weakens, mobilises and becomes irritated and inflamed. This inflammation can be seen on an MRI scan and explains the symptoms.<\/p>\n<p style=\"text-align: justify;\"><span class=\"tooltipck\" id=\"tooltipck92767\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">Non-weight-bearing<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Foot on the ground but not taking the weight of the body.<\/span><\/span><\/span> X-rays of the foot can confirm the diagnosis as they are able to show the presence of the extra bone. In atypical cases or when the diagnosis is unclear, an MRI scan can show the inflammation between the navicular bone and accessory navicular, and therefore confirm that this is what is causing the pain.<\/p>\n<\/div><div class=\"one_third_last tt-column\"><p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1536 alignnone\" src=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2024\/08\/os-naviculaire3-EN.webp\" alt=\"\" width=\"220\" height=\"247\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-958 size-medium\" src=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/01\/os-naviculaire2-1-166x300.jpg\" alt=\"\" width=\"166\" height=\"300\" srcset=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/01\/os-naviculaire2-1-166x300.jpg 166w, https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/01\/os-naviculaire2-1.jpg 246w\" sizes=\"(max-width: 166px) 100vw, 166px\" \/><\/p>\n<\/div><br class=\"clear\" \/><p>&nbsp;<\/p>\n<p style=\"text-align: justify;\">\n<div class=\"hr_shadow\">&nbsp;<\/div><\/p>\n<h2><strong>Symptoms<\/strong><\/h2>\n<p>Possible symptoms include: <img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1026 alignright\" src=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/02\/zone-doulour-os-nav-300x191.jpg\" alt=\"\" width=\"300\" height=\"191\" srcset=\"https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/02\/zone-doulour-os-nav-300x191.jpg 300w, https:\/\/chirurgie-du-pied.net\/en\/wp-content\/uploads\/sites\/2\/2021\/02\/zone-doulour-os-nav.jpg 400w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<ul>\n<li>Pain on the inner side of the foot slightly below and in front of the ankle.<\/li>\n<li>A hard <span class=\"tooltipck\" id=\"tooltipck92770\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">prominence<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">&#8230;or lump in common language.<\/span><\/span><\/span> in the same area corresponding to the accessory navicular.<\/li>\n<li><span class=\"tooltipck\" id=\"tooltipck92773\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">Oedema<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Swelling caused by a build-up of fluid in the body&#8217;s tissues.<\/span><\/span><\/span> may also occur.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p class=\"western\" align=\"justify\"><span lang=\"en-GB\">The pain can worsen on impact (e.g. when the foot hits the ground when running) or if the ankle gets twisted and can therefore end up being wrongly attributed to a foot or <strong><span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/chirurgie-du-pied.net\/en\/la-cheville-pathologies-et-interventions\/ankle-sprain\/\">medial ankle sprain<\/a><\/span><\/strong>.<\/span><\/p>\n<p>&nbsp;<\/p>\n<div class=\"hr_shadow\">&nbsp;<\/div><h2><strong>Treatment<\/strong><\/h2>\n<p style=\"text-align: justify;\">Rest, icing and pain medication can all help to treat acute episodes of pain (e.g. if you twist your ankle) but do not prevent it from coming back.<\/p>\n<p style=\"text-align: justify;\">For this reason, surgery is the treatment of choice. The procedure requires a 5 cm incision to be made and takes 45 minutes. It consists of removing the accessory navicular, repairing the tibialis posterior tendon and then reinserting it into the navicular bone using an <span class=\"tooltipck\" id=\"tooltipck92775\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">anchor<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Harpoon-shaped device that the surgeon fixes in the bone, with threads that come out of the anchor being used to stitch the tendon to the bone.<\/span><\/span><\/span>. The incision is then closed using subcuticular continuous sutures which provide the best cosmetic results.<\/p>\n<p style=\"text-align: justify;\">\n<div class=\"hr_shadow\">&nbsp;<\/div><\/p>\n<h2><strong>FAQs<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"text-align: justify;\"><span style=\"color: #3366ff;\"><strong>Is rest enough?<\/strong><\/span> Rest will relieve the pain initially. However, on resuming your activities, the same process will probably cause the pain to gradually come back.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">An accessory navicular was not found on my X-ray, but it certainly seems like there is one.<\/span><\/strong>\u00a0Make sure that you get X-rays of the foot and not the ankle. They also need to be <span class=\"tooltipck\" id=\"tooltipck92778\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">non-weight-bearing<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Foot on the ground but not taking the weight of the body.<\/span><\/span><\/span> X-rays and NOT <span class=\"tooltipck\" id=\"tooltipck92781\" rel=\"time=300|delayOut=500|offsetx=0|offsety=0\"><span style=\"color: #3366ff;\">weight-bearing<\/span><span class=\"tooltipck-tip\" style=\"width:150px;\"><span class=\"tooltipck-inner\">Foot on the ground taking the weight of the body.<\/span><\/span><\/span> X-rays.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">Are MRI scans routine?<\/span><\/strong> No, they are only performed if there is doubt over whether the accessory navicular is causing the pain.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">Can the operation be done as an outpatient procedure?<\/span><\/strong> Yes, provided that you have friends or family who can help you.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">Can children have this operation?<\/span><\/strong> Yes, provided that the ossification of the navicular bone is at an advanced stage (this usually happens between the ages of 10 and 13). An X-ray can be performed to check for this.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">Is the operation painful?<\/span><\/strong> The majority of patients who undergo this surgery do not experience a significant amount of pain. In any case, pain medication will be provided.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">Will I be able to walk after the operation?<\/span><\/strong> Yes, but you will have to use crutches for 10 to 15 days.<\/li>\n<li style=\"text-align: justify;\"><strong><span style=\"color: #3366ff;\">When can I play sports again after the operation?<\/span><\/strong> After 12 weeks.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\nAccessory navicular<br \/>\n&nbsp;<\/p>\n<p>Symptoms<br \/>\nPossible symptoms include: <\/p>\n<p>Pain on the inner side of the foot slightly below and in front of the ankle.<br \/>\nA hard prominence&#8230;or lump in common language. in the same area corresponding to the accessory navicular.<br \/>\nOedemaSwelling caused by a build-up of fluid in the body&#8217;s tissues. may also occur.<\/p>\n<p>&nbsp;<br \/>\nThe pain can worsen on impact (e.g. when the foot hits the ground when running) or if the ankle gets twisted &#8230;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template_rightnav.php","meta":{"footnotes":""},"class_list":["post-913","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - 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