Navicular: Difference between revisions

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The navicular bone is one of the seven bones which make up the tarsus of the [[Ankle and Foot]]. It is located on the medial aspect of the foot, next to the cuboid bone, anterior to the head of the talus and posterior to the cuneiform bones. It is one of the five bones of the midfoot.
The navicular bone is one of the seven bones which make up the tarsus of the [[Ankle and Foot]]. It is located on the medial aspect of the foot, next to the cuboid bone, anterior to the head of the talus and posterior to the cuneiform bones. It is one of the five bones of the midfoot.
=== Structure  ===
=== Structure  ===
The navicular is a small irregular bone with a shape being described as pyriform. [Golano]. Its posterior surface is concave and there are two faint ridges anteriorly to correspond with the articulation with the three cuneiform bones. There is a large protuberance on the inferomedial aspect of the navicular bone called the navicular tuberosity. [2 Palastaga ]This is  
The navicular is a small irregular bone with its shape being described as pyriform [Golano]. Its posterior surface is concave and there are two faint ridges anteriorly to correspond with the articulation with the three cuneiform bones. There is a large protuberance on the inferomedial aspect of the navicular bone called the navicular tuberosity [palastanga] which is often simple to palpate in the area directly anteroinferior to the medial malleolus.


== Function  ==
== Function  ==
The navicular is sometimes referred to as the keystone of the medial longitudinal arch of the foot, corresponding to its location at the peak of the arch and its role in maintaining the arch of the foot.


=== Articulations  ===  
=== Articulations  ===  
Acetabulum pedis
The acetabulum pedis is the common name for the talocalcaneonavicular joint and forms the subtalar articular complex along with the posterior talocalcaneal joint. It has some of the morphological characteristics of a ball and socket joint which let to its name. [1] The skeletal structures included are the posterior articular surface of the navicular bone, and the anterior and middle articular surface of the calcaneus that articulate with the head and the anteromedial surface of the talus. These bones are stabilized by the plantar calcaneonavicular ligament (spring ligament) on the medial aspect and the lateral calcaneonavicular ligament (a component of the bifurcate ligament) on the lateral aspect.


Plantar calcaneonavicular ligament
The acetabulum pedis is the common name for the talocalcaneonavicular joint and forms the subtalar articular complex along with the posterior talocalcaneal joint. It has some of the morphological characteristics of a ball and socket joint which led to its name [1]. The skeletal structures included are the posterior articular surface of the navicular bone, and the anterior and middle articular surface of the calcaneus that articulate with the head and the anteromedial surface of the talus. These bones are stabilized by the plantar calcaneonavicular ligament (spring ligament) on the medial aspect and the lateral calcaneonavicular ligament (a component of the bifurcate ligament) on the lateral aspect.


The plantar calcaneonavicular ligament, otherwise known as the spring ligament is a group of ligaments that bond the calcaneus and the navicular to perform as a “socket” for the head of the talus. There are some controversies regarding the morphology of this ligament. While some former researchers believed that it made up of two fascicles of fibrocartilaginous component, more current studies describe that the spring ligament is composed of two different ligaments: the superomedial and the inferior calcaneonavicular ligaments. Some recent investigators even include the talonavicular fascicle of the superficial component of the deltoid ligament as a part of the spring ligament complex.[5][8][9]
===Muscle and Ligamentous Attachments  ===
The only muscle attachment on the navicular is the tendon of the [[tibialis posterior]]. This a muscle located within deep compartment of the posterior aspect of the tibia and the tendon extends inferioraly around the medial malleolus to insert on the navicular tuberosity. [2]


The superomedial calcaneonavicular ligament, also known as the ligamentum neglectum, is a quadrangular ligament originally considered as the component of the tibiocalcaneonavicular ligament. It originates from the anteromedial margins os the sustentaculum tali which extended to the anterior margin of the calcaneal anterior articular surface. From its origin, the superomedial calcaneonavicular ligament concavely fans out to anterodorsolateral direction to a broad insertion at the margin of the navicular posterior articular surface. On the dorsal aspect, it attaches with the thick fibrocartilaginous surface that performs as the base of the fibrous tunnel of the posterior tibial tendon.[5][8][9]
There are many ligamentous attachments to the navicular bone.
The plantar calcaneonavicular ligament attaches inferiorly and is otherwise known as the spring ligament. It is a group of ligaments that connect the navicular to the calcaneus, forming a type of socket for the head of talus. [deveny] although the extent of its structure and morphology is debated in literature [deveny]


The inferior calcaneonavicular ligament is a trapezoidal-shaped ligament that arises from the superior portion of the coronoid fossa of os calcis, just anterior to the sustentaculum tali. Its insertion is on the lateral aspect of the navicular beak on the plantar aspect of the navicular, just lateral to the superomedial calcaneonavicular ligament insertion. The inferior calcaneonavicular ligament performs as one of the main static stabilizers of the longitudinal arch of the foot.[5][8][9]
The superomedial calcaneonavicular ligament originates from the anteromedial margins of the sustentaculum tali on the talus bone. From there, it extends in an anterodorsolateral direction to the posterior aspect of the navicular and also attaches to the the posterior tibial tendon [3]


Bifurcate ligament
The inferior calcaneonavicular ligament is arises from the superior portion of the coronoid fossa, anterior to the sustentaculum tali. Its insertion is on the lateral, plantar aspect of the navicular, just lateral to the superomedial calcaneonavicular ligament insertion. The inferior calcaneonavicular ligament performs as one of the main static stabilizers of the longitudinal arch of the foot [9]


Also known as the Chopart ligament, the bifurcate ligament is a Y-shaped ligament that consists of two components that have different origins, which are the lateral calcaneonavicular ligament and the medial calcaneocuboid ligament. The lateral calcaneonavicular ligament originates from the lateral side of the anterior talar articular surface, anteromedially from the sinus tarsi. It courses anterodorsomedially and inserts in the superior segment of the lateral end of the navicular. Two bundles of fibers form this ligament. While the superior fibers are long, resistant, and lays superficial, the inferior fibers are short and rest deep. The medial calcaneocuboid ligament originates from the lateral side of the lateral calcaneonavicular ligament’s origin, on the anterior aspect of intermediary tubercle. It extended anteroinferior and attached to the dorsal side of the cuboid. Together, these fibers form a durable band that facilitates the lateral foot stabilization.[10][11]
The bifurcate ligament is a Y-shaped ligament consisting of two components arsising from different origins: The lateral calcaneonavicular ligament and the medial calcaneocuboid ligament. The lateral calcaneonavicular ligament originates from the lateral side of the anterior talar articular surface, anteromedially from the sinus tarsi. Together, these fibers form a durable band that facilitates the lateral foot stabilization.[10]
=== Muscle attachments  ===


== Clinical relevance  ==
== Clinical relevance  ==
[[Navicular Drop Test]]
There are several clinical conditions which involve the navicular directly. The navicular is often subject to developing stress fractures and can lead to [[Navicular stress syndrome]]. Müller Weiss syndrome is a spontaneous adult onset osteonecrosis of the navicular bone which may be picked up radiographically. In children, there is also a similar condition, although distinct from Müllers Weiss syndrome called Kohlers syndrome.
[[Navicular stress syndrome]]
 
[[Accessory Navicular Bone]]
One common association is the abnormality called[[Accessory Navicular Bone]]
== Resources  ==
 
The navicular is also used clinically within the [[Navicular Drop Test]]. This involved palpation of the navicular tuberosity and measuring the degree of inferior travel.


= References  =
= References  =
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Anatomy, Bony Pelvis and Lower Limb, Navicular Bone
Anatomy, Bony Pelvis and Lower Limb, Navicular Bone
Devindra Prapto; Mark A. Dreyer.
Devindra Prapto; Mark A. Dreyer.
Samim M, Moukaddam HA, Smitaman E. Imaging of Mueller-Weiss Syndrome: A Review of Clinical Presentations and Imaging Spectrum. AJR Am J Roentgenol. 2016; W1-W11. doi:10.2214/AJR.15.15843 -
[[Category:Anatomy]] [[Category:Bones]]
[[Category:Anatomy]] [[Category:Bones]]

Revision as of 22:04, 20 September 2020

Original Editor - Alex Benham

Top Contributors - Alex Benham, Lucinda hampton, Fasuba Ayobami and Kim Jackson

Description[edit | edit source]

The navicular bone is one of the seven bones which make up the tarsus of the Ankle and Foot. It is located on the medial aspect of the foot, next to the cuboid bone, anterior to the head of the talus and posterior to the cuneiform bones. It is one of the five bones of the midfoot.

Structure[edit | edit source]

The navicular is a small irregular bone with its shape being described as pyriform [Golano]. Its posterior surface is concave and there are two faint ridges anteriorly to correspond with the articulation with the three cuneiform bones. There is a large protuberance on the inferomedial aspect of the navicular bone called the navicular tuberosity [palastanga] which is often simple to palpate in the area directly anteroinferior to the medial malleolus.

Function[edit | edit source]

The navicular is sometimes referred to as the keystone of the medial longitudinal arch of the foot, corresponding to its location at the peak of the arch and its role in maintaining the arch of the foot.

Articulations[edit | edit source]

The acetabulum pedis is the common name for the talocalcaneonavicular joint and forms the subtalar articular complex along with the posterior talocalcaneal joint. It has some of the morphological characteristics of a ball and socket joint which led to its name [1]. The skeletal structures included are the posterior articular surface of the navicular bone, and the anterior and middle articular surface of the calcaneus that articulate with the head and the anteromedial surface of the talus. These bones are stabilized by the plantar calcaneonavicular ligament (spring ligament) on the medial aspect and the lateral calcaneonavicular ligament (a component of the bifurcate ligament) on the lateral aspect.

Muscle and Ligamentous Attachments[edit | edit source]

The only muscle attachment on the navicular is the tendon of the tibialis posterior. This a muscle located within deep compartment of the posterior aspect of the tibia and the tendon extends inferioraly around the medial malleolus to insert on the navicular tuberosity. [2]

There are many ligamentous attachments to the navicular bone. The plantar calcaneonavicular ligament attaches inferiorly and is otherwise known as the spring ligament. It is a group of ligaments that connect the navicular to the calcaneus, forming a type of socket for the head of talus. [deveny] although the extent of its structure and morphology is debated in literature [deveny]

The superomedial calcaneonavicular ligament originates from the anteromedial margins of the sustentaculum tali on the talus bone. From there, it extends in an anterodorsolateral direction to the posterior aspect of the navicular and also attaches to the the posterior tibial tendon [3]

The inferior calcaneonavicular ligament is arises from the superior portion of the coronoid fossa, anterior to the sustentaculum tali. Its insertion is on the lateral, plantar aspect of the navicular, just lateral to the superomedial calcaneonavicular ligament insertion. The inferior calcaneonavicular ligament performs as one of the main static stabilizers of the longitudinal arch of the foot [9]

The bifurcate ligament is a Y-shaped ligament consisting of two components arsising from different origins: The lateral calcaneonavicular ligament and the medial calcaneocuboid ligament. The lateral calcaneonavicular ligament originates from the lateral side of the anterior talar articular surface, anteromedially from the sinus tarsi. Together, these fibers form a durable band that facilitates the lateral foot stabilization.[10]

Clinical relevance[edit | edit source]

There are several clinical conditions which involve the navicular directly. The navicular is often subject to developing stress fractures and can lead to Navicular stress syndrome. Müller Weiss syndrome is a spontaneous adult onset osteonecrosis of the navicular bone which may be picked up radiographically. In children, there is also a similar condition, although distinct from Müllers Weiss syndrome called Kohlers syndrome.

One common association is the abnormality calledAccessory Navicular Bone

The navicular is also used clinically within the Navicular Drop Test. This involved palpation of the navicular tuberosity and measuring the degree of inferior travel.

References[edit | edit source]

Epeldegui T, Delgado E. Acetabulum pedis. Part I: Talocalcaneonavicular joint socket in normal foot. J Pediatr Orthop B. 1995;4(1):1-10.

Anatomy, Bony Pelvis and Lower Limb, Navicular Bone Devindra Prapto; Mark A. Dreyer. 

Samim M, Moukaddam HA, Smitaman E. Imaging of Mueller-Weiss Syndrome: A Review of Clinical Presentations and Imaging Spectrum. AJR Am J Roentgenol. 2016; W1-W11. doi:10.2214/AJR.15.15843 -
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