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Dorsal medial enlargement of the navicular bone
20%
63/321
Plantar medial enlargement of the navicular bone
63%
203/321
Dorsal lateral enlargement of the navicular bone
7%
21/321
Plantar lateral enlargement of the navicular bone
22/321
Central enlargement of the navicular bone
3%
9/321
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An accessory navicular occurs as a plantar medial enlargement of the navicular bone. It exists as an accessory bone or as a completely ossified extension of the navicular.An accessory navicular is a common idiopathic condition of the foot that presents with an enlargement of the navicular bone. Diagnosis is made with plain radiographs of the foot showing a plantar medial enlargement of the navicular bone. Treatment is generally conservative with shoe modifications and a short period of cast immobilization in patients with symptoms. Surgical excision is indicated for patients with progressive pain who have failed extended nonoperative management.Grogan et al. reviewed 22 skeletally immature patients with 39 accessory tarsal navicular bones. They noted that the external oblique view was found to be the best radiographic view to demonstrate the accessory navicular. They reported that those with symptomatic accessory naviculars who were treated surgically after the failure of conservative treatment had complete resolution of their preoperative pain. They concluded that histological findings in the surgical specimens included areas of micro-fracture through the cartilaginous synchondrosis, acute and chronic inflammation, and cellular proliferation indicative of attempted repair, suggesting that these changes are consistent with the theory that chronic chondro-osseous tensile failure can occur in this condition and is responsible for the clinical findings.Cha et al. designed a prospective, comparative study of simple excision and the Kidner procedure in children and adolescents with flatfoot and evaluated functional and radiographic outcomes. They reported that in children and adolescents with accessory navicular and flatfoot, simple excision and the Kidner procedure both gave satisfactory results. They concluded that both procedures minimally restored the medial longitudinal arch similarly.Incorrect Answers:Answers 1,3-5: An accessory navicular occurs as a plantar medial enlargement of the navicular bone.
3.3
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