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Kohler Bone Disease

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Kohler Bone Disease, Kohler's Disease, Avascular Necrosis of the Tarsal Navicular, Tarsal Navicular AVN

  • See Also
  1. Osteochondritis
  2. Pediatric Limp
  • Epidemiology
  1. Rare condition
  2. Age: Onset at age 2-8 years
  3. Gender: Boys affected 3-5 times more commonly than girls
  • Pathophysiology
  1. Unknown etiology
  2. Not associated with Trauma
  3. Avascular necrosis of Tarsal Navicular
  • Symptoms
  1. Presents with midfoot pain and Pediatric Limp (favoring unaffected side)
  • Signs
  1. Local pain, tenderness, swelling over Tarsal Navicular
  1. Flattening, sclerosis, fragmentation and irregularity of Tarsal Navicular
  • Management
  1. Protect from excessive Trauma
  2. Rest
  3. Ice Therapy
  4. Short walking cast for 7-8 weeks
  • Prognosis
  1. Spontaneous recovery by rule
  2. Complete Navicular re-ossification in 2-3 years
  • References
  1. Achar (2019) Am Fam Physician 99(10): 610-8 [PubMed]
  2. Atanda (2011) Am Fam Physician 83(3): 285-91 [PubMed]
  3. Borges (1995) J Pediatr Orthop 15(5): 596-8 [PubMed]