Painful navicular bone
Painful Accessory Navicular, os tibiale externum, supernumerary navicular bone.) is an important bone from the group of accessory bones of the foot from the point of view of clinical manifestations.
Accessory Navicular Bone is a congenital malformation that occurs in up to 10% of the population. It is often bilateral, located at the inner edge of the scaphoid bone, and is observed in women 2 times more often than in men.
In most patients, the accessory scaphoid does not cause clinical manifestations and is an incidental finding during examination for other reasons. The accessory navicular bone can be considered a concomitant sign of longitudinal-transverse flatfoot.
There are three types of accessory scaphoid:
Type I is a separate bone within the scaphoid and tibialis posterior tendon.
Type II - accessory bone, which is connected to the scaphoid bone through synchondrosis;
Type III - the accessory ossicle is a separate fragment tightly fused with the scaphoid bone
Types II and III are the most significant in the clinical picture of “painful scaphoid.”
From a clinical point of view, this disease is of great importance. Patients are often misdiagnosed with a non-existent scaphoid fracture when a specialist mistakes the supernumerary scaphoid for a fragment. It is not uncommon for the medial edge of the navicular bone, which protrudes under the skin, to come into contact with shoe components and leads to the formation of a painful area, even purulent bursitis in the medial area of the foot. Diagnosis is based on an assessment of the clinical data obtained by the doctor during an examination of the patient’s foot, characteristic complaints and data from a patient interview. The basis of diagnosis is instrumental research methods, radiography of both feet in frontal and lateral projections while standing in support.
Treatment. Treatment begins with conservative measures, which are effective in many cases. If there is no effect from conservative treatment, if pain persists, or foot deformity develops, patients are recommended surgical treatment, about which detailed information can be obtained at an outpatient appointment with a specialist in foot and ankle problems.
Causes of pain
The cause of discomfort in the area of localization of the navicular part is damage to the foot in the form of a fracture or dislocation. They arise as a result of direct (falling object on the foot) and indirect trauma. Pain also occurs in case of an accident or prolonged excessive load on the leg, which occurs during professional sports. Dislocations of this joint often occur in children, since their ossification of the foot is not sufficiently developed. Sometimes discomfort occurs due to the fact that an additional navicular bone grows in the foot. This is a hereditary phenomenon that appears in every generation.
Dislocation of the navicular joint
The joint can be dislocated due to twisting of the foot.
Most often it occurs as a result of a twisted foot. In this case, the talus remains in place, and the scaphoid, along with the cuboid and calcaneus, move. During such injuries, the ligamentous-articular apparatus suffers significantly. Tendons, the muscles of which are attached to the foot, rupture. The vascular wall is destroyed, which causes hematomas and bruises.
In a child, dislocation of this formation is associated with insufficient strength and rigidity of the connections between the bone formations of the lower limb.
Causes and symptoms
As a result of injury, the alignment of bones with each other is significantly disrupted. This causes severe pain and swelling. The posterior sections are predominantly affected. This is due to the peculiarities of the localization of the scaphoid bone. In this case, the foot is significantly deformed, acquiring a varus curvature. Passive and active movements in the lower parts of the foot are limited and often completely impossible. This is due to severe pain, which developed as a result of a violation of the integrity of the ligaments and muscles, as well as due to the development of a soft tissue hematoma.
Diagnosis and treatment
Before reducing the dislocation, local anesthesia is given.
Only a traumatologist can perform the reduction of a dislocation. Before the procedure, the affected area is numbed using anesthesia and intraosseous anesthesia. It is important to carry out intervention as soon as possible after the injury, because delay will allow the swelling and hematoma to increase and affect the entire limb. This will make it much more difficult to compare the foot bones with each other.
Fracture of the scaphoid region
This injury impairs the function of the entire lower limb, since a small bone is located in close proximity to the ankle joint. She is often injured during the winter season when she slips and falls unsuccessfully. Often this bone heals incorrectly, which is associated with a frequent lack of adequate diagnosis and insufficient treatment.
Causes and symptoms
People at risk for developing ankle and foot fractures include:
- elderly people who have impaired bone tissue trophism;
- women after menopause;
- overweight patients;
- young people leading an active lifestyle.
After an injury, protruding bone is visible at the site of injury.
When an injury occurs, the foot begins to rapidly swell, and the entire lower limb hurts greatly. In this case, a bone protrudes at the top of the foot with severe deformation. The victim also has significant varus deformity. Immediately after this, the skin at the site of injury turns blue, and active and passive movements are completely impossible.
The slightest touch to a limb during a fracture causes severe pain.
Methods for treating the navicular bone of the foot
When the navicular bone of the foot is damaged, therapy includes applying a plaster cast. The procedure is performed in a hospital setting only by a qualified traumatologist. After a month and a half, a control x-ray is performed. It allows you to assess the degree and correctness of bone fusion. You can relieve pain immediately after an injury with injections of painkillers, which are used if necessary.
How to treat Keller's disease?
Treatment of Keller disease 1 is carried out using conservative methods. These include techniques for unloading the foot and creating conditions for its immobilization, that is, ensuring the foot is immobile. In this case, it is necessary to apply a cast, which is recommended to be worn for at least four weeks. After its removal, the mobility of the foot is limited for some more time.
To achieve a speedy recovery of the patient, medications are prescribed that will help improve blood circulation and metabolic processes in the affected area. To numb the area where Keller's disease occurs, you can take an analgesic and a non-steroidal drug.
In addition to medication therapy, physiotherapy and thermal procedures are prescribed. Orthopedic shoes and insoles are recommended for children with Keller disease to help maintain the shape of the foot. Advanced cases of pathology require surgery. During the intervention, the doctor forms two channels in the affected bone, in which new vessels grow over time, improving tissue nutrition. As a result, rapid recovery of the affected bone is observed, as well as the disappearance of pain syndrome.
In any case, only the attending physician should prescribe treatment for a particular pathology. Otherwise, you can cause complications, including complete deformation of the foot.
Protruding femurs and fibulas
Protruding femurs may indicate destruction of the hip joint. In young women, such a clinical sign often appears after an unsuccessful pregnancy, during which the pelvic bones were displaced. This is fraught with poor posture in the lumbosacral spine, divergence of the pubic bones and displacement of the femoral heads in the acetabulum.
If the fibula protrudes, then deformation of the ligamentous, fascial and tendon apparatus can be suspected. Loose knee ligaments often cause the fibula to become unstable. Its gradual shift begins. There is an effect of her head bulging. This condition is dangerous. It can cause frequent fractures of the fibula. The help of an experienced orthopedist is required.
How to treat a sprained foot?
The dislocation must be adjusted by a doctor who has the appropriate qualifications. Reduction requires the administration of anesthesia or intraosseous anesthesia. It is necessary to carry out such a procedure as soon as possible, since rapidly spreading swelling and hematoma can significantly complicate treatment.
After reduction, a plaster cast is applied, which is removed after 4 weeks. During the rehabilitation period, massage, physiotherapy and physical therapy are necessary. It is recommended to move with the help of crutches, which reduce the load on the damaged area. You can use arch supports to help prevent foot deformation.
If it is impossible to correct the dislocation, and also if it is old, an operation is performed.
Protruding bone on big toe
If the bone protrudes on the finger, then this is a clinical sign of deformation of the interphalangeal or phalangeal-metatarsal joint. There are three phalanges in the toes (the exception is the big toe - there are two phalanges). The phalanges are connected to each other using joints. When a joint is destroyed, the head of the bone is displaced. Since the subcutaneous tissue in this place has minimal thickness, and the muscles are located exclusively on the lateral and lower surfaces, it begins to seem that the bones are bulging.
Often the bone on the big toe protrudes with deforming osteoarthritis. If the patient's big toe bone protrudes, this indicates a valgus deformity and deviation of the phalanx towards the other toes. If corrective measures are not taken, deformation of the remaining joints will soon begin.
Symptoms of a scaphoid fracture
As with any fracture, there is swelling, pain and limitation of movement in the damaged joint. Typically, the pain and dysfunction are less severe than with a fracture of the adjacent radius and may improve over several days or weeks, but do not go away completely. The scaphoid is characterized by pain in the projection of the anatomical snuffbox (it can be easily detected between the tendons when the thumb is extended), while palpation of the radius remains painless. A person with a wrist injury cannot fully straighten the arm at the wrist joint, and therefore cannot lean on it.
Keller's disease: symptoms and causes
This disease is divided into two subtypes. The first subtype is characterized by damage to the scaphoid bone, and the second - by damage to the metatarsal bones. That is why two types of the disease can be distinguished - Keller disease 1 and Keller disease 2.
Unfortunately, it is impossible to name the exact causes of Keller disease 1. Many experts are of the opinion that the development of the disease is based on impaired local blood circulation, which, in turn, provokes bone necrosis.
Poor circulation can occur in the following cases: with congenital characteristics of the blood circulation of the extremities, wearing the wrong shoes, foot injury, acquired foot defects. The blood circulation process can also be disrupted if the blood vessels are in poor condition, which is observed with diabetes, as well as with endocrine and metabolic disorders in the body.
When this disease develops, swelling occurs in the area of the inner edge of the back of the foot. Palpation of the affected area is accompanied by pain, which also occurs when walking or other stress on the foot. If the disease develops in a child, he becomes tearful, quickly gets tired when walking and complains of pain in the foot. When walking, the child's foot rests on its outer part, which causes gait disturbance.
Inflammation, as well as increased local temperature, as symptoms of Keller disease 1, are not observed. Keller's disease 1 is accompanied by damage to only one foot, without the possibility of the lesion spreading to the second. The maximum duration of the presence of the disease in the human body is 1 year, after which the disappearance of symptoms or persistent bone deformation is observed.