Kohler’s Disease in Kids

The navicular bone in the foot is just in front of the ankle joint and forms what is the apex of the arch of the foot. As it is at the apex of the arch it is subjected to substantial pressure and load when walking and in other activities. In adults if the load on that bone is too much for it to take, a stress fracture can result. In younger children a particular condition known as Kohler’s disease can affect the navicular bone. This is an osteochondritis or ischaemic reaction within the bone due to the loads on the bone affecting the blood supply. This generally presents as a limp in the child typically around the age of five with vague pain over the navicular. On x-ray the navicular is much thinner compared to the other side. Generally the treatment for this is to put the child into a cast or walking brace to limit weight-bearing and to limit load on the bone so it can heal up. This is generally needed for six or so weeks and is extremely important as that ischaemic area in the bone needs to be reversed.


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