This time, I would like to talk about painful external tibia.
Painful external tibia may not sound familiar to you, but it is a condition that can be seen in elementary school children.
It is a disease that should be known not only by those involved with elementary school students but also by medical personnel.
Outline
External tibia is a remnant of secondary ossification in the rough surface of the navicular bone (foot).
The majority of patients are asymptomatic, but when pain appears for some reason, it is called "painful external tibia".
There is a method to determine the condition called Veitch's classification.
Type 1: Separated from the navicular bone and located within the tibialis posterior tendon
Type 2: Fibrous connection to the rough surface of the navicular bone
Type 3: Bony union with the navicular bone.
Clinical Findings
The patient himself may be concerned about the deformity of the foot and visit the doctor.In the early stages of the disease, the patient may experience motion pain, and in severe cases, pain on walking may occur.
It can be caused by sprained ankle joint or exercise with new shoes.
Some adults also have external tibia, but trauma may be the trigger for its detection.
Cases
22-year-old female
Sprained her left foot while playing handball.
Very severe pain appeared, making it difficult to walk.
There was marked tenderness and swelling on the medial side of the scaphoid bone.
We suspected a bone fragment avulsion of the outer tibia and found it on imaging examination.It was judged to be a traumatic rupture, and surgery was recommended.
Conclusion
The external tibia, called the excess bone, does not have to be there, but it is anatomically related to the tibialis posterior muscle.
It can be caused by repeated traction or by a sprain, so the syndrome must be confirmed when a sprain occurs.I don't know how to prevent excess bone, but there are ways to reduce sprains as much as possible, so if you are worried about sprains or have a habit of spraining, you need to be careful.
