Лак обладает глянцевым сияющим эффектом, широкой удобной кистью и хорошей стойкостью.
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Accessory navicular syndrome is the painful condition caused by the presence of the accessory navicular. Well, is the statement a bit confusing? Let me explain. The accessory navicular is a bone in the foot that is not supposed to be present. But in some very rare cases, this extra bone (sometimes can also be a cartilage piece) is present by birth. This bone exists in the arch of the foot. The presence of this bone though not common, is not abnormal either as most people are not even aware of its existence unless and until it begins to cause pain which we call accessory navicular syndrome.
People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse.
It?s common for any symptoms to present during adolescence, when bones are maturing, though problems may not occur until adulthood. You may notice a bony prominence on the inner side of the midfoot. There may or may not be redness and swelling around this bump, especially if it rubs against footwear. You may be prone to blisters or sores in the area. Pain generally involves a vague ache or throbbing in the midfoot and arch as well, especially when you?re active. Many people with this syndrome develop flat feet, too, which can create additional strain in the foot.
Diagnosis is fairly simple based on an examination by your doctor. He or she will palpate the navicular bone, and based on the location of pain will suspect an accessory navicular. The doctor will also observe your gait to see if you are flatfooted. At this point an x-ray will make the definitive diagnosis. Other causes of pain in the same area of the foot would include a fracture of the navicular bone or possibly tendonitis or even a partial tear of the tibialis posterior tendon that inserts into the navicular. In these cases there is usually a history of trauma. People with a naturally "large" navicular bone may also develop a bursitis due to chronic shoe pressure.
Non Surgical Treatment
The initial treatment approach for accessory navicular is non-operative. An orthotic may be recommended or the patient may undergo a brief period of casting to rest the foot. For chronic pain, however, the orthopedic surgeon removes the extra bone, a relatively simple surgery with a brief rehabilitation period and a very good success rate.
If conservative care does not alleviate the problem then surgical intervention should be considered. The most common procedure for this condition is known as the Kidner procedure where a small incision is made over the navicular bone. The accessory navicular is identified and dissected free from the posterior tibial tendon. The posterior tibial tendon is then reattached to the remaining navicular bone.
Accessary bone syndrome affects overpronators because of irritation in this area. Improper fitting shoes can also irritate the area. When pain becomes such that it changes running form or becomes intolerable, something needs to be done. Surgery alone without addressing causative factors is useless. Pain returns and new cartilage returns in the tendon, and the inflammation causes pain.
This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.
What are the signs/symptoms of Accessory Navicular Syndrome? Pain in the foot following trauma (such as after an ankle sprain) Chronic irritation from shoes or other footwear rubbing against the bone. A visible bony prominence on the inner side of the foot just above the arch. Redness and swelling of that area. Vague pain or throbbing in the arch mostly occuring during or after periods of physical activity. Symptoms appear most often during adolescence, but some may not occur until adulthood.
Accessory navicular syndrome is diagnosed by asking about symptoms and examining the foot for skin irritation and swelling. Doctors may assess the area for discomfort by pressing on the bony prominence. Foot structure, muscle strength, joint motion and walking patterns may also be evaluated.
Non Surgical Treatment
For less severe symptoms, decreasing or modifying activity, such as avoiding aggravating activities, may suffice. Ice and NSAIDS can be used to help control pain. An arch support or an orthotics may help to stabilize the arch during this time. When rubbing on the bump causes pain, a doughnut pad can be worn. Exercises to increase range of motion and improve movement should still be used.
If non-operative treatment fails to relieve the patient’s symptoms, surgical intervention may be warranted. The standard operative treatment of an accessory navicular is a Kidner procedure. However, if surgery is undertaken it is important that it address the underlying source of the patients pain.
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