Navicular Disease

Kohler disease is a rare bone disease, where the navicular bone of the foot for the moment, loses its blood supply (avascular necrosis). It is caused when the navicular bone temporarily loses its blood supply. Indeed, the bone tissue dies and the collapse of bone. Navicula is the last tarsal bone to harden the children. This bone can be compressed between the already ossified talus and cuneiform when the child becomes heavier. Compression involves the vessels in the central spongy bone leading to ischemia. Subsequently, the perichondrial ring of vessels sends the blood supply, which allows rapid revascularization and new bone formation.

It is characterized by limping caused by pain and swelling of the feet. It occurs most frequently in children aged three and seven men and five times more often influences as it does females. Typically, one foot is affected. Appear to grow out of childhood illness and affected bones regain their size, density and structure in a year. For some, however, symptoms can last as long as two years. In this rare condition, children present with local tenderness and the soft inside of the foot on the navicular bone. The child may walk with more weight on the lateral side of the foot.

Swelling and redness of the soft tissues are common. The disease usually affects boys, but it can also affect girls. Five is the age of the boys more often affected and patients often complain of pain during the summit. This is probably due to the onset of ossification in girls occurs at age 18-24 months, while among boys, ossification occurs at age 24-30 months. If the disease is suspected of Kohler, radiographs of the foot must be obtained. X-rays are usually abnormal and lesions of the navicular bone in the middle of the foot. The symptoms usually disappear spontaneously with minimal treatment.

The standard treatment is to place the child in a short leg walking cast for several weeks for symptoms to subside. Modest exercise is often beneficial. An arch support UCB if the pain is less. Non-steroidal anti-inflammatory drugs can help. The child may have to rest from sports for a few weeks until the acute pain is relieved. A weight-bearing cast below the knee is recommended. Total casting time is approximately 6-8 weeks. The cast is better in the virus moderate (10-15 ยบ) that is associated with moderate equinovarus (10-20 ยบ). In mild cases, soft arch supports may be the only treatment necessary.