Understanding.
The accessory navicular bone is an additional bone near the insertion of the posterior tibial tendon. Often asymptomatic, it can become painful with sports or friction from footwear.
The assessment.
The examination and radiographs look for correlation with the pain and assess for possible flat feet. An MRI can clarify local or tendon involvement.
Treatments.
Footwear adjustments, orthotics, and a temporary reduction of stress are often sufficient. Immobilization may be necessary. In cases of persistent failure, surgery on the accessory bone and tendon insertion may be considered.
Follow-up.
Resumption is gradual, depending on the disappearance of pain and, after surgery, tendon healing.
What procedure can be offered?
Depending on the size of the bone and the condition of the foot, the procedure may involve removing the accessory bone and reinserting the tendon, or attempting bone fusion. Significant flat feet may require additional correction.
Protecting the bone and tendon
A boot or immobilization, with limited weight-bearing, may be necessary. Follow-up appointments assess healing and gradual recovery. Pain from the hardware, poor tendon consolidation, or impaired healing are among the risks.
Your questions.
Should an accessory bone discovered by chance be removed?+
No. Its presence alone does not justify intervention.
Is it always a fracture?+
No. This may be a characteristic present since birth; the assessment distinguishes a traumatic lesion.
Is a simple insole sufficient?+
Yes, in certain forms, if it supports the foot without increasing friction on the bony prominence.