19 Jul What is Kohler’s Disease?
Kohler’s Disease is a rare bone disorder affecting the tarsal navicular bone in the arch of the foot. This condition affects young children between the ages of 5 to 10 years, especially boys. It typically affects one foot.
How does Kohler’s Disease Develop?
Children at this particular age (between 5 to 10 years) still have developing bones. The tarsal navicular bone, being the last bone to form, is in this case compressed between the talus and the cuneiform bones of the foot.
Moreover, the tarsal navicular bone has the worst blood supply. This limit in blood supply leads to the death of bone tissue (avascular necrosis), development of stress fractures and the eventual breaking up of the bone.
The fact that the tarsal navicular bone is over-compressed by surrounding bones and lacks adequate blood supply before ossifying (hardening) can cause it to quickly break apart, leading to Kohler’s disease.
The pieces of broken bone usually harden back together with time. In this way, Kohler’s Disease becomes self-limiting. The term ‘self-limiting’ means that, when left on its own, the condition will resolve itself. There is no need for surgery in the case of Kohler’s Disease.
Signs and Symptoms of Kohler’s Disease
- A painful, swollen foot.
- The affected area becomes inflamed.
- The length of the foot arc is tender to the touch.
- The child may begin limping or may change their gait to avoid applying pressure on the affected foot.
- The flow of blood to the tarsal navicular bone, leading to avascular necrosis. Reasons leading to the limit in blood supply to the navicular bone is not yet known.
What Causes Kohler’s Disease?
The exact cause of Kohler’s disease is yet to be discovered.
However, orthopedic specialists believe that Kohler’s disease might be linked to an injury around the tarsal navicular bone. Delayed bone formation (ossification) is another cause of Kohler’s disease.
The blood supply to the navicular region may be limited as the child gains weight between the ages of four to six. This is because the delayed ossification would lead to a weaker bone that is easily compressed under the weight of the child. As a result, the blood vessels to the navicular bone are compressed as well, and the bone tissue dies because of deficiency of blood supply.
A Phoenix podiatrist will perform X-Ray imaging of the injured foot beside the healthy foot to compare the navicular bones.
The painful feeling originating from the arc of the foot is also another marker.
Treatment of Kohler’s Disease
- A soft orthotic can be used to support the navicular bone as it is allowed to heal.
- Anti-inflammatory medication may be prescribed to keep the inflammation in check.
- A podiatrist can prescribe painkillers (analgesics) to manage the pain.
- A short leg walking cast may be recommended in some cases.
- The child is advised to stay off of their feet for longer periods of time to aid in the healing process.
As stated earlier in this article, Kohler’s disease is a self-limiting disease. When left on its own, the bone will recover, and the child will become asymptomatic. Kohler’s disease can last between a range of a couple of months, to a few years in extreme cases.
When a child has painful feet, Oasis Foot and Ankle offers top treatment for relief. This may include orthotics, medications and other options. Call Oasis today for treatment with the top Phoenix and Scottsdale foot specialists!