Topic Resources
Köhler bone disease is death
(necrosis) of the tarsal navicular bone (a bone at the arch of the foot)
due to loss of its blood supply.
Köhler bone disease is an osteochondrosis, which is a group of disorders of the growth plate of bones
that occur when the child is growing rapidly. Doctors are not sure what
causes osteochondrosis, but the disorders do seem to run in families. Osgood-Schlatter disease, Legg-Calvé-Perthes disease, and Scheuermann disease are other osteochondroses.
Köhler bone disease is caused by a poor blood supply to the
tarsal navicular bone. The poor blood supply causes the tarsal navicular
bone to die and collapse. Why the blood supply is poor is not known.
Köhler bone disease usually affects children aged 3 to 5 years
(more commonly boys) and typically affects only one foot. The foot
becomes swollen and painful, and the arch of the foot is tender. Weight
bearing and walking increase discomfort, and the child’s manner of
walking (gait) is impaired.
X-rays
show that the navicular bone is initially flattened and hardened and
later breaks into fragments before healing and hardening back into bone.
X-rays comparing the affected side with the unaffected side help assess
how far the disease has progressed.
Bones of the Foot
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Treatment
-
Rest and pain relievers
-
Sometimes a cast
Köhler bone disease rarely lasts beyond 2 years. Rest and pain
relief are required, and excessive weight bearing must be avoided. This
disease usually resolves without treatment and without any long-term
consequences. In severe cases, having the child wear a below-knee
walking plaster cast for a few weeks may help. Crutches are often not needed with a walking cast.
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