What disease is elbow bone and how to treat it?

Clinical anatomy The scaphoid of the foot constitutes the top of the medial longitudinal arch, and the posterior tibial tendon stops at the medial edge and plantar surface of the scaphoid from the lower back of the medial malleolus and extends forward to the medial two cuneiform bones and the second and third metatarsal bases, so that the tendon plays a role in setting off the scaphoid to maintain the longitudinal arch. Because the scaphoid is located at the top of the longitudinal arch, it bears a large force, and any abnormal development of the scaphoid will affect the stability of the longitudinal arch. The common abnormal development of scaphoid is that there are a pair of bones at the medial tubercle of scaphoid, called accessory scaphoid or lateral scaphoid, which are mostly bilateral symmetry. When the accessory scaphoid exists, the scaphoid node is underdeveloped. There are two anatomical types of accessory navicular bone; One is round, has no contact with scaphoid, grows on the posterior tibial tendon like patella, and its bottom surface is composed of hyaline cartilage. Slide into the canal along the posterior tibial tendon. Generally, it will not produce symptoms. The second type is round or triangular, which touches the scaphoid. This type is easy to be injured and has symptoms.

The existence of accessory navicular bone is a structural defect, which affects the stability of foot. From the analysis of pathological anatomy, the following effects can occur: ①Kidner pointed out that the orientation of posterior tibial muscle is different from that of normal people because of the existence of accessory scaphoid. Under normal circumstances, the posterior tibial tendon passes through the "underside" of the medial end of the scaphoid and ends at the bottoms of the second and third medial cuneiform bones and the second and third metatarsals. When there is an accessory navicular bone, the posterior tibial tendon extends on the "top" of the internal surface of the accessory navicular bone and stops firmly on the accessory navicular bone. This change of walking direction and stopping point will destroy the inherent function of the posterior tibial muscle to lift the longitudinal arch of the foot, make the foot varus, and lead to symptoms caused by flat feet and strain. ② When the foot is varus, the accessory scaphoid is easy to contact with the medial malleolus, which hinders varus. In order to avoid this impact, the abductor muscle of the foot contracts reflexively, which also promotes the occurrence of valgus and vertical collapse of the arch of the foot for a long time. ⑧ The stopping point of the posterior tibialis muscle changes, and the tendon is lengthened to form an angle, so the tension is weakened, and the setting-off force against the internal longitudinal arch is also weakened, which is easy to form flat feet. (4) Long-term walking friction, bursitis occurs here, tenosynovitis can also occur in the posterior tibial muscle, resulting in swelling and pain symptoms.

Symptoms and diagnosis-As many as two sides suffer from this disease, and they feel pain in the soles of their feet or inside their feet after standing for a long time. The medial scaphoid is swollen with tenderness and occasionally bursitis. Resistance foot varus examination, the pain in the medial foot is aggravated. Some cases have tenderness along the posterior tibial muscle. Athletes often suffer from acute ankle sprain, which is easily misdiagnosed as lateral collateral ligament injury.

X-ray shows that there are small bones with neat edges at the back of the scaphoid, and the density is the same as that of the scaphoid. Some are irregular at the junction with navicular bone, sometimes cystic, or both sides of the junction are hardened. Some accessory navicular bones have scattered punctate shadows, and sometimes the bone density increases, showing signs of ischemia and necrosis.