Additional scaphoid bone - SportWiki encyclopedia
- 6Rehabilitation and return to sport
Additional navicular bone
Several nuclei of ossification participate in the formation of the scaphoid bone. Of all the bones of the foot, this bone is more often than not split - in 20-25% of the population. Not merged with the main bone mass, the medial part forms a bone protrusion, sometimes causing pain. Symptoms occur in younger school age.
There are three types of additional navicular bones.
- Type I is a small bone fragment in the region of the tendon of the posterior tibial muscle, sometimes called the external tibia.
- Type II is a larger fragment than in type I, connected to the scaphoid bone by a dense cartilaginous jumper.
- Type III - formation on the scaphoid bone of the medial protruding part, which is an additional fragment that merged with the main bone.
Complaints and physical signs
An additional scaphoid bone can cause flushing, swelling and pain, and sometimes blisters and calluses on the protruding part of the foot. More often these signs mark at II type of disease. The pain is especially characteristic for skiers, skaters and hockey players, as they are forced to wear shoes. Ordinary footwear can also provoke pain if its inner edge is located in the projection of the scaphoid bone. The cause of the symptoms is usually a fracture of the jumper connecting the extra scaphoid bone with the main one.
Normally the scaphoid bone becomes visible on radiographs from the second year of life, but in some cases it can not be detected until five years. Radiographs in a direct, lateral and oblique projection confirm the diagnosis and help in differential diagnosis.
Additional scaphoid bone
Not all people have the same number of bones in their feet. This also applies to the hands. In these anatomical areas, there may be additional small bones, and some small bones can be merged into one larger bone. This state sometimes causes problems.
The navicular bone is one of the small bones of the middle parts of the foot. It, together with the other bones of the foot, forms the rise of the foot in the form of an arch. The tendon of the posterior tibial muscle, which is quite large, passes under the arch of the foot and is attached to the scaphoid bone. This powerful tendon is involved in maintaining the vault. If there is an additional scaphoid bone, it is located on the inside in the place where the tendon of the posterior tibial muscle is attached to the scaphoid bone.
The additional navicular bone is a congenital anomaly. Once the skeleton fully ripens, the scaphoid and additional navicular bone merge into a single bone. If the fusion did not occur, then these bones remain connected only by a fibrous tissue or cartilage. Girls have this pathology more often.
Not all those who have an additional navicular bone have problems. Problems can occur if the size of the additional scaphoid bone is large enough or when a fibrous junction between the scaphoid and additional navicular bone is broken after trauma. At a large size, the additional scaphoid bone can mechanically injure the foot, causing pain. If the fibrous junction between the scaphoid and the extra scaphoid bone is damaged, there are movements that are believed to cause pain. The tendon of the posterior tibial muscle during walking constantly draws for an additional scaphoid bone, reinforcing the movements. Fibrous tissues are long-lasting healing tissues, and constant movements inhibit healing.
The main manifestation of this pathology is pain. If the extra scaphoid bone is an accidental finding on the chest X-ray and does not manifest itself in any way, then no treatment is needed. Pain usually occurs on the inner side of the foot, where one can often palpate a small tubercle. With an aggravation, walking can become quite painful. As noted earlier, the condition is more common in girls. This pathology often manifests itself in adolescence.
The diagnosis is made on the basis of the patient's questionnaire, medical examination by an orthopedic traumatologist and performing an X-ray( x-ray) of the foot. On examination, local edema and tenderness of soft tissues from the inside over the scaphoid bone are revealed. X-ray, as a rule, confirms the presence of an additional scaphoid bone. No other tests are required.
Conservative treatment In the vast majority of cases, treatment begins with a conservative treatment. Operative treatment is usually considered only when all conservative methods can not control pain. If the leg becomes painful and the presence of an additional scaphoid bone is confirmed radiologically, immobilization of the foot in the plaster or the tire can be recommended. This is necessary to immobilize the fibrous connection between the scaphoid and the additional navicular bone, which provides the conditions for a fibrous connection between the bones. Anti-inflammatory drugs( diclofenac, voltaren, indomethacin) may be prescribed. If the pain subsides, then further treatment is not necessary. Wearing the instep can subsequently ease the burden on the arch of the foot, which will reduce the likelihood of exacerbation. Surgical treatment of If conservative treatment is unsuccessful, then surgical treatment is indicated. Kidner's operation is the most common operation for the treatment of this pathology. Its meaning is that an additional scaphoid bone is removed through a small incision, and the tendon of the posterior tibial muscle is fixed to the scaphoid bone. After the operation, the immobilization of the foot and ankle is shown.
Rehabilitation after conservative treatment of Patients with painful extra scaphoid bone need to undergo a course of physiotherapy procedures. To relieve the tension of the posterior tibial muscle, the doctor can recommend a series of stretching exercises. You can use special orthopedic shoe liners or orthopedic shoes to protect the inflamed area.
This approach will immediately return to normal walking, but it is necessary to limit more active activity and physical activity for several weeks, until pain and inflammation subsides. Treatment is aimed at reducing edema and pain. Physiotherapy procedures include ultrasound, thermal procedures and massage, if there are no contraindications. A physiotherapist may also prescribe other physiotherapy procedures. Rehabilitation after surgical treatment of For several days after the operation, crutches will have to be used. Sutures are removed after 10 - 14 days. It should be expected that a full recovery will not occur before six weeks.
Why does it hurt to stop when walking?
After each kilometer passed, the legs are loaded with a weight of 60 tons. Although the limbs can withstand many things, they are also susceptible to stress and disease.
Diseases of the front of the foot
The anterior third of the foot consists of metatarsal bones, phalanges and ligaments between them. Corns, blisters, mycoses, hammer fingers, Morton's neuroma, valgus deformation, gout - various conditions are associated with the pathology of these elements of the foot. Metatarsalgias are any pain, the cause of which is not established. Traumatic injuries or too narrow shoes increase the likelihood of pain in the foot when walking.
The movement is extremely beneficial for health, but the pain that hinders each step is a serious cause for concern.
Extensory tendonitis of the foot develops due to constant overstrain of the shin - prolonged walking in uncomfortable shoes can be the main reason. The pain increases when you try to bend or unbend your fingers.
Stress fractures threaten people with excess weight, which creates an increased burden on the bones. Even experienced athletes engaged in marathons and jogging can suffer from repeated bouts of pain. They increase during walking and do not stop with time.
Diseases of the middle part of the foot
The middle third of the foot is represented by the bones of the tarsus and their joints. They account for a significant part of the medial longitudinal arch of the arch of the foot. Pain in the middle part of the stalks when walking appears as a result of fatigue fractures, pinching of the lateral plantar nerve, horse deformation( associated with too high arch) sprains of the tibia of the tibia, tendon syndrome, extensor tendonitis. Treatment directly depends on the diagnosis, which it is better not to delay, as cascading pain can be aggravated.
Fractures of the second, third and fourth metatarsal bones are common in people who are engaged in the morning run. Gradually, it feels that the foot stops hurting when walking. Pain rises, accompanied by swelling.
The navicular bone runs along the inside of the middle of the foot, and its fractures are more complex. Initially, the pain only disturbs during exercise and passes after rest, but over time recovery periods become longer.
Fractures in the joint of Lisfranca, formed by the accumulation of small bones in the arch area, are caused by the anatomy of the first and second metatarsal bones that do not have ligaments. This leads to dislocations during sharp turns or jumps.
Micronutrition of the thick plantar fascia more often affects the heel area, but female legs whose joints are unstable suffer from painful attacks after a morning ascent. Medicines, physiotherapy come to the aid of patients.
If the foot is sore while walking, the effect of the shoe can not be ruled out, especially to people who are involved in sports, have a baby, suffer from arthritis. Too soft outsole flexes and does not support the foot, therefore after any walk there is discomfort.
Diseases of the back of the foot
The posterior third of the foot consists of the calcaneus and the talus, and the joints connecting them to each other. The answer to the question of why the heel hurts lies in the anatomy of the foot. When walking the heel, the first takes a blow to the ground, and its fabrics are influenced by huge forces. Pain in this area is the most private complaint in adults. Unsuitable footwear and injuries - top the list of reasons that relate to this symptom. Plantar fasciitis, bruised heel, stress fractures, tarsal tunnel syndrome, pinching of the medial calcaneus nerve, Achilles tendon bursitis and calluses bother the heels, with the left leg suffering more often than the right leg.
How to return the ease of gait?
Any disease is easier to prevent because irreversible processes need expensive and prolonged treatment. Care is the main condition for the beauty and health of the feet. You can not walk for a long time in shoes with a narrow nose and high heels. It is advisable to use special orthopedic insoles appointed by an orthopedist.
Try to bring excess weight to the norm and include in the diet products with calcium to strengthen the bones. If possible, it is better to avoid long standing on the legs, not to sit, throwing one leg to the other, as this worsens blood circulation. Doing sports and other physical activities should be reasonable, and training shoes - with quality insteps.
After a hard day's work, the feet need a decent rest. Care procedures include relaxing baths with sea salt and essential oil, as well as light massage.
It is better to solve the problems with the legs with an orthopedist who develops a full cycle of gymnastics for each day. Even the usual exercise "bicycle", stretching your feet in different directions, from yourself and to yourself with a towel reduces the load on the arch. If you raise your legs up and just shake them, you can get rid of swelling, normalize the flow of blood. Take care of leg health!
Anatomy of the foot |The structure of the foot |Ankle |Ankle joint |Sports medicine
The skeleton of the foot consists of three sections: tarsus, metatarsus and fingers.
Bones of the tarsus
The posterior part of the tarsus consists of the talus and calcaneus, the anterior one is navicular, cuboidal and three wedge-shaped.
The astrakhan bone is located between the distal end of the shin bones and the calcaneus, being a kind of bone meniscus between the shin bones and with the bones of the foot .The talus bone has a body and a head, between which is a narrowed place - the neck. The body on the upper surface has an articular surface - a block of the talus, which serves to articulate with the bones of the shin. The front surface of the head also has an articular surface for articulation with the scaphoid bone. On the inner and outer surfaces of the body there are articular surfaces, articulating with the ankles;on the lower surface there is a deep furrow that separates the articular surfaces that serve for its articulation with the heel bone.
The calcaneal bone of forms the posterior part of the tarsus. It has an elongated, oblate shape and is the largest of all bones of the foot .It distinguishes the body and protrudes posteriorly a well-felt tubercle of the calcaneus. This bone has articular surfaces that serve for articulation on top with a talus bone, and in front with a cuboid bone. On the inside of the calcaneus there is a protrusion - the support of the talus bone.
The navicular bone is located at the inner edge of the of the foot. It lies in front of the ramming, behind the wedge-shaped and inside of the cuboid bones. At the inner edge, it has a navicular bumpy bone, turned downwards, which is well probed under the skin and serves as an identification point for determining the height of the inner part of the longitudinal arch of the foot. This bone is convex anterior. It has articular surfaces, articulating with adjacent bones.
The cubical bone is located at the outer edge of the of the foot and articulates from the back with the heel, inside with the scaphoid and outer wedge, and in front with the fourth and fifth metatarsal bones. On its lower surface is a furrow, in which lies the tendon of the long fibular muscle.
The sphenoid bone ( medial, intermediate and lateral) lies in front of the scaphoid, inside of the cuboid, behind the first three metatarsal bones and constitute the anterior-internal section of the tarsum.
Each of the five metatarsal bones has a tubular shape. They are distinguished base, body and head. The body of any metatarsal bone in its shape resembles a triangular prism. The longest bone is the second, the shortest and the thickest - the first. On the bases of the bones of the metatarsal are articular surfaces that serve to articulate with the bones of the tarsus, as well as adjacent metatarsal bones, and on the heads - articular surfaces for articulation with proximal phalanges of the fingers. All the bones of the metatarsus are easy to feel from the back, as they are covered with a relatively thin layer of soft tissue. The bones of the nose lie in different planes and form a vault in the transverse direction.
Fingers of the foot consist of phalanges. As with the brush, the first finger of the foot has two phalanges, and the rest - three. Often two phalanges of the fifth finger join together so that its skeleton can have two phalanges. Distinguish between proximal, middle and distal phalanges. Their essential difference from phalanges of the brush is that they are short, especially distal phalanges.
On the stop, the , like the brush, has sesamoid bones. Here they are much better expressed. Most often they occur in the area of the connection of the first and fifth metatarsal bones with proximal phalanges. Sesamoid bones increase the transverse vascularity of the metatarsus in its anterior part.
The mobility of the foot provides several joints - ankle , subtalar, talon-calcaneus-navicular, tarsus-metatarsal, metatarsophalangeal and interphalangeal.
Ankle joint is formed by the bones of the shank and the talus bone. The articular surfaces of the bones of the lower leg and their ankles, like a fork, cover the block of the talus bone. Ankle joint has a block-shaped form. In this joint, around the transverse axis passing through the talus block, bending( movement towards the foot of the sole ) and extension( movement towards its posterior surface) are possible. The amount of mobility during flexion and extension is 90 °.In view of the fact that the block is somewhat tapering from the rear, when the is bent it becomes possible to bring it some lead and lead. The joint is strengthened with ligaments located on its inner and outer sides. The medial( deltoid) ligament located on the inner side is approximately triangular in shape and extends from the medial malleolus towards the scaphoid, talus and calcaneus bones. On the outside, there are also ligaments that extend from the fibula to the talus and calcaneus bones( anterior and posterior talon-peroneal ligaments and the calcaneocutaneous ligament).One of the characteristic age features of this joint is that in adults it has great mobility towards the foot surface of the , while in children, especially in newborns, towards the rear of the foot .
The subtalar joint is formed by the talus and heel bone, located in the rear part of the joint. It has a cylindrical( somewhat spiral) shape with an axis of rotation in the sagittal plane. The joint is surrounded by a thin capsule, equipped with small ligaments.
In the anterior part between the talus and heel bone there is a talus-calcaneus-navicular joint. It is formed by the head of the talus, the heel( its anterior-upper articular surface) and the scaphoid bone. The Tar-heel-navicular joint has a spherical shape. Movement in it and in the subtalar joints are functionally interfaced;they form one combined articulation with the axis of rotation passing through the head of the talus and the calcaneal tubercle. Around this axis is the pronation
|( pronatio: lat prono, pronatum tilt forward ) - the rotational movement of the limb or part of it( for example, the forearm, hand or foot) inwards, i.e.this is the rotation of the limb of a person around its long axis so that its front surface is about. ..|
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