photos by Sydney Foot and Ankle Surgeon Damien Lafferty

Approximately 2.5% of the population are born with an accessory navicular. There are three types of this condition with type 2 being the most commonly symptomatic. The fibrocartilagenous union between the ossicle and the navicular can be torn, particularly when it occurs in an excessively pronated foot type. The tibialis posterior tendon will contract and pull on the ossicle as the patient attempts to hold the arch up.

This patient was in her 20s and had suffered marked pain in her left medial midfoot with a painful prominence. She had worn orthotics for many years, however, marked pain in the region and generalised arch pain persisted.

I removed the accessory navicular and debulked the hypertrophied medial navicular and inserted a HyProCure stent to control the excess pronation. Note the before and after images depicting the absence of the accessory bone and the titanium stent on the right postoperative image.

If you have any specific questions or would like to discuss similar cases, feel free to contact me.

Also read:
Biomechanics of a pathology (bunions and pes planus)
Post-operative pes planus/flat feet/excess pronation
Pes planus
Hyperpronation cure

(This content is intended for healthcare professionals only)