A self limiting avasulcar necrosis of the navicular usually unilateral and affects children, most often boys.  Onset is at age 4 in boys and age 5 in girls.  The navicular is subjected to repetitive compressive forces during weight bearing.  Since the navicular is last bone in foot to ossify, delayed ossification appears to make the navicular more vulnerable to compressive damage.  These compressive forces can occlude the vessels of the soft ossification center rendering it avascular.

Symptoms

- painful limp, shifting weight to lateral edge of foot to relieve pressure on longitudinal arch;
- pain tenderness, and swelling develop in the region of the navicular;
- contraction of tibialis posterior muscle may be painful;

Custom orthotics are indicated for best results of both long term treatment prognosis and immediate pain relief.  This orthotic will support the longitudinal arch of the foot and decrease localized pressure to the navicular.  This relief of pressure will restore vascular supply and prevent necrosis.

One Response to “Köhler’s Disease”

1. » Treatable Conditions says:

   August 30, 2009 at 6:34 pm

   [...] Köhler’s Disease [...]