An accessory navicular is defined as an extra bone in the foot, and oftentimes it causes moderate to severe discomfort. Depending on the severity, your doctor may recommend a non-surgical treatment to alleviate the pain, or surgery if treatment doesn’t decrease symptoms. Here is an explanation of the surgical process for Accessory Navicular Removal.
- Follow patient-specific surgical center recommendations regarding how to prepare for surgery, anesthesia, etc.
- Before surgery you will be given regional anesthesia and Novocain-like medication to provide complete pain relief.
- After the anesthesia is administered you will be heavily sedated and placed on your stomach.
- Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot.
- The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed.
- Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed.
- A splint will be placed on the foot for stabilization and immobilization.
- You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist.
- Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication.
- Use narcotic pain medications before bed or if numbness in your foot begins to dull.
- Schedule a post-op visit for 4 weeks after the procedure.
Post-surgical timeline for Accessory Navicular removal
(Consult your doctor for patient-specific post-op care as recommendations may vary. The below timeline is a general guideline for routine accessory navicular removal)
First 3-5 days
- Elevate leg for 23 hours a day for the first three days. Elevation will help reduce swelling, which may last more than 4 months.
- Move and flex your toes after the nerve block mitigates. Motion will help decrease pain and swelling.
- Use strong narcotics for pain management. Begin to use a lesser pain control medication like Motrin or Tylenol after 3-5 days.
First 2 weeks
- You can return to work after 10-14 days if your job is non-labor intense. Check with your doctor to ensure it is safe to return to work.
- Visit your clinic to have your original cast replaced after two weeks. A secondary cast will be worn for an additional 4 weeks.
Beyond 2 weeks
- Do not place weight on the foot for 6 weeks. This will give the tendon ample time to heal.
- Return to the surgical center after 6 weeks to have your secondary cast removed and a fracture boot placed on you foot. This will assist in weight bearing.
- You can return to labor-intensive work after 3 months, but speak with your doctor about your specific case and work requirements.
- Do not get cast wet. Use a waterproof cast cover (such as a Drypro) to keep your cast dry during showers.
- Patients who underwent a procedure on their left foot may operate an automatic transmission vehicle within a week, but consult your surgeon about operating a vehicle when taking specific pain-management medication.
- Patients who had the procedure done on their right foot should wait until the foot has healed enough to bear weight and they feel safe operating a vehicle.
- If you experience foot pain after 3 months, consult your doctor.
Lance Silverman, MD
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