Dancers With Symptomatic Accessory Navicular

NewsBot · Jan 28, 2012

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Management of Dancers With Symptomatic Accessory Navicular: 2 Case Reports.
Smith TR.
J Orthop Sports Phys Ther. 2012 Jan 25.

STUDY DESIGN:
Case report.

BACKGROUND:
Symptomatic accessory navicular can be a source of pain and disability. Treatment considerations for dancers may be different because of the increased demands on the foot, the repetitive nature of the movements, and the specific footwear required. The purpose of this report is to describe the management (1 conservative and 1 post-operative) of 2 adolescent dancers with symptomatic accessory navicular.

CASE DESCRIPTIONS:
Case 1 was an 11 year old female who underwent surgical excision of a symptomatic accessory navicular. Case 2 was a 15 year old female managed non-surgically following a traumatic injury that caused pain judged to be related to her accessory navicular. Treatment included pain management, range of motion exercises, trunk and lower extremity strengthening, balance and proprioception training, orthoses, cross-training, and a guided return-to-dance progression.

OUTCOMES:
Both patients had improved pain, dance technique, strength, and patient-reported outcome scores that allowed a full return to dance.

DISCUSSION:
The 2 dancers presented here had foot pain believed to be related to a symptomatic accessory navicular. In both cases, treatment targeted specific impairments to improve function and disability. The guided progression of activities was intended to facilitate a return to dance that protected healing tissues and prevented a recurrence of symptoms. Clinicians should be aware of the effect of non-surgical management of a symptomatic accessory navicular in the young dancer and potentially effective treatment options for this condition.
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Admin2 · Jan 28, 2012

Related threads:
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NewsBot · Sep 22, 2016

Surgical Treatment of the Accessory Navicular (Os Tibiale Externum) in Dancers.
Rietveld, A. B. M. (Boni); Diemer, Willemijn M.
Journal of Dance Medicine & Science . 2016, Vol. 20 Issue 3, p103-108. 6p.

This study is to draw attention to a relatively common anatomical anomaly and its possible operative treatment in dancers. The accessory navicular, or os tibiale externum, is an accessory bone on the medial side of the navicular of the foot at the insertion of the posterior tibial tendon (PTT). It can cause obvious hyperpronation, medial foot pain, and a limited and painful relevé in dancers. To the best of our knowledge, this is the first report on the operative treatment of the accessory navicular exclusively in dancers. Six dancers (10 feet) were treated in our clinic for a symptomatic accessory navicular Type II. Five of them (eight feet) underwent surgery, two unilaterally and three bilaterally (at the same time). All five had an excellent result at mean follow-up of 4.7 years, given that they fully resumed their professional dance activities without restriction, discomfort, or residual symptoms. One patient stopped dancing for unrelated reasons and became symptom free without further (surgical) treatment. Although no conclusions can be drawn from a retrospective case series and other treatment modalities were not considered, simple excision of a symptomatic accessory navicular Type II seems to be a good choice in dancers.
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