Occasionally, an accessory navicular (an extra foot bone) becomes painful. If non-surgical treatment in a boot or insert does not decrease the symptoms, surgery to remove this bone can relieve your pain. The surgery is performed on an outpatient basis and typically produces fantastic results. Learn more about the procedure below.
Are you dealing with foot pain or discomfort caused by an extra bone in your foot?
If so, let Dr. Silverman help. For more information about accessory navicular treatment, keep reading.
What Happens Before Accessory Navicular Surgery?
The surgical center will provide you with individualized advice in the days and weeks leading up to your operation. On the day of your surgery, the anesthesiologist will give you a regional anesthesia known as a Popliteal nerve block. You will be given medication to induce “twilight sleep,” placed on your stomach, and a small needle will be used to inject Novocain-like medication around the nerve in the back of your leg. It gives complete pain relief that lasts 12 to 36 hours. Patients report extraordinary satisfaction with this type of anesthesia.
What Happens During Accessory Navicular Surgery?
You will be heavily sedated during the operation and will not feel discomfort during surgery. A tourniquet is placed around your thigh and an incision is made along the inside of the foot. Next, the posterior tibial tendon is elevated off of the accessory navicular and the bone is removed. The tendon is then repaired with sutures or suture anchors directly to the normal remaining bone. The wound is closed and a splint is placed.
What Happens After Accessory Navicular Surgery?
You will be permitted to leave the surgical center once your anesthesiologist is satisfied that you have recovered. During this recovery time your family member may take your prescription to the nearest pharmacy. You will be given crutches. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember post operative pain is much easier to control with prevention. Call to schedule your post-operative visit for four weeks from surgery when you are able.
Accessory Navicular Excision General Recovery Timeline
This timeline is a general guideline. Your post-operative course may vary.
Cast is on for two weeks and then replaced for another four weeks. A fracture brace is used until eight weeks after surgery.
| Elevation | 23 hours / day for 3 days; swelling may last over 4 months. |
| Motion | Move your toes when the block resolves. This will decrease pain and swelling and improve healing. Begin ankle motion at 4 weeks. |
| Walking | No weight bearing until 6 weeks when tendon heals to bone. Then progress as tolerated to a normal gait. |
| Bathing | Keep cast dry. Use a Drypro. There are no restrictions after the cast is removed. |
| Pain Control | Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Motrin. |
| Work | Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor will take at least 3 months. |
| Driving | Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until healing is adequate and they feel safe. |
Routine Clinic Visits
| 2 weeks | Replace cast. Obtain a Physical therapy prescription to start at 8 weeks post-op. |
| 6 weeks | Remove cast and put on fracture boot. Use After care brace from our office for swelling control. |
| 3 months | Return if you have pain, other concerns, or per Dr. Silverman’s instructions. Minimal feelings of discomfort may linger, your overall comfort level improves over a year. |
| Other issues | Hardware removal is recommended if it is bothersome. |
| ********** | If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. |
For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!