Diagnosing and Treating Symptomatic Accessory Naviculars

There is an extra bone that some people have called the accessory navicular. The accessory navicular is located on the inside of the navicular bone, which is in the arch area of the foot. It is an issue because it disrupts the attachment of the posterior tibial tendon into the insertion point on the navicular. which is in the arch area of the foot, that disrupts the attachment of the posterior tibial tendon. There are three types, with Type II being the most common. Many people who have an accessory navicular do not know that they have it until they become symptomatic, either through an acute injury or overuse. There are multiple treatment options ranging from non-surgical and conservative, like physical therapy, to complete excision of the extra bone and reinserting the posterior tibial tendon. The most common surgical procedure is called the Kidner procedure, but this can also be modified to fit the patient’s specific needs. The accessory navicular is hard to see in diagnostic imaging due to the small size and the location. Accessory naviculars also have an undetermined relationship with flat foot, which can exacerbate the symptoms of a painful accessory navicular. This bone affects a small percentage of people, but recurrent foot pain is a hindrance for daily life and exercise. This research looks at reducing that pain. This presentation discusses the diagnosing and treatment of a symptomatic accessory navicular