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The middle third of the bone lacks blood vessel penetration and it bears the majority of the load applied to the tarsal bones during weight bearing. Its vascular and biomechanical properties make it susceptible to injury. This may partly explain a higher risk of stress fractures and osteonecrosis in this location.
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or swelling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion and the way the patient walks may also be evaluated.
A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. [1] [2]The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.
Between these superior articulations and the equivalents on the talus is the tarsal sinus (a canal occupied by the interosseous talocalcaneal ligament). [ citation needed ] At the upper and forepart of the medial surface of the calcaneus, below the middle talar facet, there is a horizontal eminence, the talar shelf (also sustentaculum tali ). [ 2 ]
The height of a person's arch is determined by the height of the navicular bone. Collapse of the longitudinal arches results in what is known as flat feet. [5] A person with a low longitudinal arch, or flat feet will likely stand and walk with their feet in a pronated position, where the foot everts or rolls inward.
The sinus tarsi located in the hindfoot, it is contained by the calcaneus, talus, talocalcaneonavicular joint, and the bottom of the subtalar joint. [1] There are five ligamentous structures present inside it: the intermediate, medial, and lateral roots of the inferior extensor retinaculum; the cervical ligament, and the interosseous talocalcaneal ligament.
The first mechanism is a stress fracture which happens commonly in athletes, [7] and the other mechanism is a high energy trauma. The navicular bone is a keystone of the foot: it is part of the coxa pedis and articulates with the talus, first, second and third cuneiform, cuboid and calcaneus.
[2] [3] Dr. A. Köhler noted that children with foot pain displayed characteristics, within their x-rays, of irregularity in growth and development of the tarsal navicular bone in the foot. Furthermore, Köhler disease is known to affect five times more boys than girls and typically, only one foot is affected.