Os Naviculare excision and tibialis posterior advancement
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An Os Naviculare is a medial midfoot bony prominence at the point of the Tibialis Posterior insertion that presents with localised pain (and possibly swelling) in both adults and children.
If activity restriction and orthotic management fails to control symptoms simple excision of the bony prominence is indicated.
An Os Naviculare can be present in a foot with a normal arch profile or a pes planus. If in the latter a calcaneal osteotomy at the time of surgery may be indicated. Strong evidence for re-routing the insertion of the Tibialis posterior through the navicular to improve the medial arch profile (known as the Kidner procedure) is lacking.
Author:Mark Herron FRCS
Institution: The Wellington Hospital, London, UK.
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Question 1 of 15
Which one of the following statements is true about the presentation and symptoms of an Os Naviculare ?CorrectIncorrect
Question 2 of 15
An Os Naviculare that is in complete bony continuity with the Navicular is best classified as which one of the following?CorrectIncorrect
Question 3 of 15
In a patient with a medial Navicular prominence and a stiff pes planus which one of the following is true about imaging?CorrectIncorrect
Question 4 of 15
Which one of the following is not appropriate operative management of a symptomatic Os NaviculareCorrectIncorrect
Question 5 of 15
In decieding whether a Calcaneal osteotomy will be of use as part of the surgical reconstruction which one of the following is not a consideration ?CorrectIncorrect
Question 6 of 15
Which one of the following is not true of the approaches used for this procedure ?CorrectIncorrect
Question 7 of 15
The following is true of the medial hindfoot anatomy in the vicinity of the surgical approach used for an Os NaviculareCorrectIncorrect
Question 8 of 15
Which one of the following is true of the insertion of the Tibialis Posterior (& in relation to this condition) ?CorrectIncorrect
Question 9 of 15
Which one of the following is true of the interface between the Navicular and an Os Naviculare ?CorrectIncorrect
Question 10 of 15
The advantages of using a suture anchor to reattach the Tibialis posterior do not include which one of the following ?CorrectIncorrect
Question 11 of 15
Once the Os Naviculare has been excised which one of the following is not an appropriate next step?CorrectIncorrect
Question 12 of 15
During the post-operative period which one of the following is correct about imaging ?CorrectIncorrect
Question 13 of 15
In the post-operative period which one of the following is correct in terms of weight-bearing ?CorrectIncorrect
Question 14 of 15
With respect to the published results of the Kidner procedure and variations on it which one of the following is correct ?CorrectIncorrect
Question 15 of 15
With respect to the published long term results of the Kidner procedure versus simple excision of the Os Trigonum which one of the following is true ?CorrectIncorrect