Dr Makemba speaks on accessory navicular

• By Uaueza Kanguatjivi

STUDIES have shown that up to 2.5 percent of individuals are born with the accessory navicular, however, throughout early childhood, this condition is not noticed.

Accessory navicular is an extra bone that is on the inner arch of the foot.

Windhoek-based General Practitioner, Doctor Nelson Makemba said accessory navicular was not part of normal bone structure.

“It is not part of normal bone structure and therefore, not present in most people. When people develop pain it becomes accessory navicular syndrome as a result of foot or ankle sprain, irritation from shoes, and or excessive activity or overuse.

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He added that treatment might involve immobilisation, using ice, pain medications, physiotherapy, orthotic devices, or surgery to remove the accessory bone.

“The pain might render one’s inability to function optimally, but when managed properly the function can be fully regained, therefore it might not necessarily be classified as a disability.”

“The prominent bony area on the medial or inner side of the foot or arch. Pain, swelling and occasional redness may occur. This is often aggravated by standing or walking for long periods of time

Makemba explained that the condition was congenital in nature.

“The idea is to see an orthopaedic surgeon and be managed appropriately. Exercise is ideal in a controlled environment such as biokinetics, otherwise exercising by yourself might not be advisable. In conclusion it is best to always seek the help of a medical doctor,” Makemba said.

The most common procedure used to treat the symptomatic accessory navicular is the Kidner procedure. A small incision is made in the instep of the foot over the accessory navicular. The accessory navicular is then detached from the posterior tibial tendon and removed from the foot.

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According to Ortho info’s publication, there are three different types of accessory navicular. This include, extra cartilage which is turned into the bone and is found attached to the posterior tibial tendon, inside the navicular bone.

The accessory navicular can affect the insertion of the posterior tibial tendon. This tendon has the job of keeping your foot aligned and helping maintain an arch. The accessory navicular can be associated with a normal foot posture and alignment or sometimes with a flat foot (pes plasnus)

In an article published by Physio-pedia, the prevalence of an accessory navicular bone is 10 percent (range 4-21%).  Although, this may be substantially higher (45%) in Asian populations.