Navicular Anatomy

The navicular bone is one of the 26 bones in the human foot. It is important for connecting the ankle to the lower bones of our feet and helps form the arch that enables us to walk. It is prone to stress fractures, especially when athletes kick, sprint, twist, or fall.

anatomy

The human foot contains 26 bones and 33 separate joints. The navicular bone is the cuneiform bone located on the upper inner part of the midfoot. It is used to connect the ankle bone (talus) to the tarsus of the foot.

Function

Although small, the navicular bone is important for stabilizing the ankle and arch. Several ligaments and a tendon connect to the navicular bone, allowing for efficient walking.

Related conditions

Conditions affecting the navicular include:

  • fracture
  • Kohler disease
  • Mueller-Weiss syndrome
  • paranavicular syndrome

fracture

Acute fractures of the navicular bone can occur as a result of injury. Stress fractures can occur as a result of repeated stress.

Athletes often cause navicular fractures when kicking, twisting, or sprinting. Pain and changes in the way you walk are common in fractures. Among track and field athletes, navicular stress fractures are one of the most common causes of stress fractures.

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Depending on the severity of the fracture, treatment can be conservative or surgical. Conservative treatment includes casting to allow the bone to heal. Surgical placement of screws and casts to hold the bone in place may be required to allow time for healing.

Kohler disease

Kohler disease is a condition of avascular necrosis, or osteonecrosis, which means that bone tissue dies from a lack of the blood supply it needs to keep bones healthy. Kohler disease is most common in young children between the ages of 4 and 7. More common in boys.

In children around age 3, the navicular bone becomes calcified. As children grow, their weight gain makes the navicular bone vulnerable to compression from other bones in the foot. This compression—along with the lack of blood supply to the navicular bone—increases the chance of Kohler’s disease.

The usual symptoms are tenderness and pain in the middle of the foot. Swelling may also occur.

The disorder is self-limiting and usually corrects itself as the child matures. Anti-inflammatory medications and short walking casts are recommended treatments for pain relief.

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Mueller-Weiss syndrome

Muller-Weiss syndrome (MWS), also known as Brailsford disease, is a disease of osteonecrosis, but it occurs in middle-aged people. MWS is more common in women.

MWS can appear spontaneously, although some believe it to be caused by trauma, bone migration, or congenital causes.

Treatment with anti-inflammatory drugs and immobilization is usually successful in treating pain. If needed, surgical alternatives can be used to reduce pain and restore the arch.

paraboat syndrome

Paranavicular syndrome is the result of having an extra piece of bone or cartilage next to the navicular bone. This is a congenital disorder that is present at birth. It occurs in 4% to 14% of the population.

Most people with paranavicular syndrome are unaware of its existence unless the extra bone is causing the problem.

Trauma, sprained feet or ankles, and chronic irritation from shoes rubbing against this excess bone can all cause pain.

Flat feet or sagging arches can also cause strains in the tendons that connect to the bones, which can worsen paranavicular syndrome and create more inflammation and pain.

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Symptoms of paranavicular syndrome include:

  • Midfoot and arch pain or throbbing – usually during/after activity
  • Significant protrusion or bulge on the inside and above the arch of the foot
  • Bone redness and swelling

During puberty, cartilage calcifies and becomes bone. It is usually during this process that the symptoms of paranavicular syndrome appear. Some people don’t develop symptoms until later in life.

Pain history, examination, and X-rays confirm the diagnosis of paranavicular syndrome.

Ice to reduce swelling, anti-inflammatory drugs, physical therapy to strengthen muscles and reduce inflammation, and casts can be used to treat symptoms. Another treatment option is a custom orthopedic device that is inserted into the shoe to provide arch support.

If symptoms recur after conservative treatment, surgical removal of the additional navicular bone may be required.

treat

Recovery from scaphoid-related disorders often includes treatment with immobilization and anti-inflammatory therapy. Physical therapy and specialized insoles are often used to help prevent re-injury.