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Accessory navicular

Posted by Martin W on 9/20/02 at 07:21 (095806)

Several months ago I landed poorly during tennis but it was not for a week or more that I noted any symptoms in my ankle that then became quite swollen, and discolored on interior surface. Two months of relative inactivity, elevation etc, reduced symptoms to where I could start activity again. I did not get too far before symptoms (swelling, instability, discomfort) reappeared. MRI indicated post tibial tendon tear. Two foot ortho specialists have differed somewhat on diagnosis and treatment. First concurs with PT tear, says try casting/orthotics and then surgery if that is not successful. Second took addtl Xrays, says I have a detached accessory navicular and probable stretch (he didn't say tear) of PT. He put me in cast for 4 weeks after which I can resume activity slowly. Surgery to remove AN and re-attach PT indicated if this rest does not cause injury to scar over. Second doc does not believe in orthotics for this problem. I have a prior (25 years ago) Achilles rupture in same ankle.

Trying to find out best course and learn risks of procedures as well. What is a lay person to do? Thanks

Re: Accessory navicular

Dr. David S. Wander on 9/20/02 at 12:40 (095846)

It doesn't seem that your 2 opinions really differ very much. One wants to cast you, then try orthotics prior to surgery, the other wants to cast you prior to considering surgery. The bottom line is that if several weeks of cast immobilization don't work, orthoses may not be very successful and surgical intervention may be the only reasonable option.

Re: Accessory navicular

Martin W on 10/18/02 at 09:15 (097801)

Thanks for the feedback. A doctor friend (not an orthopod) who had the same problem said to avoid surgery if at all possible, that it will take a year for the tendon to repair itself but it will. I am very hesitant to go the surgical route and would like to fully understand the risks and probabilities before I proceed in that direction. Can you point me to any info. Thanks again

Re: Accessory navicular

Dr. David S. Wander on 9/20/02 at 12:40 (095846)

It doesn't seem that your 2 opinions really differ very much. One wants to cast you, then try orthotics prior to surgery, the other wants to cast you prior to considering surgery. The bottom line is that if several weeks of cast immobilization don't work, orthoses may not be very successful and surgical intervention may be the only reasonable option.

Re: Accessory navicular

Martin W on 10/18/02 at 09:15 (097801)

Thanks for the feedback. A doctor friend (not an orthopod) who had the same problem said to avoid surgery if at all possible, that it will take a year for the tendon to repair itself but it will. I am very hesitant to go the surgical route and would like to fully understand the risks and probabilities before I proceed in that direction. Can you point me to any info. Thanks again