• A change in the biomechanics of the navicular suspensory apparatus may relieve pain associated with navicular disease   Navicular bone: syndrome  .
• Surgery is proposed based on mechanically-based etiology and involves sectioning the collateral sesamoidean ligaments (CSL):
  • These ligaments contain a large number of nerve fibers and surgery may be a form of neurectomy.
  • Exact biomechanical role of the CSLs is unknown.
• Surgery is proposed to decrease forces on the navicular bone during the caudal phase of the stride.

Uses

• Unresponsive navicular disease   Navicular bone: syndrome  :
  • Cases in which the disease was present for >1 year showed a decreased response to surgery.
  • Surgery should be attempted early in disease course if being used.

Disadvantages

• Surgical procedure - requires general anesthesia   Anesthesia: general - overview  .
• Potential disruption of the collateral ligaments of the pastern   →   instability.
• Uncertain results.

Alternative techniques

• Conservative/medical management.
• Palmar digital neurectomy   Palmar digital nerve: neurectomy  .
• Navicular bursoscopy   Bursoscopy: overview  .

Time required

Preparation

• 30 min.

Procedure

• 30-60 min.

Decision taking

Criteria for choosing test

• Exhausted other treatment options.