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What is Kohlers?
Kohler's disease is a condition, where the navicular bone in the foot looses its blood supply temporarily and sustains a state of bone death, also called avascular necrosis. This most commonly happens in boys, however it can happen in girls. The child is usually around 4 or 5 years old, who complains of pain in the foot over the arch or inside aspect. He may walk with a limp, and tends to walk on the outer body of his foot. He may have tenderness to touch the foot and swelling might be visible.
What causes Kohlers?
The reason for this is unknown; however, it is suspected that compressive forces during activities and growth may be related. The blood supply typically returns and the bone heals all on its own. This process is usually complete over two year’s time.
Is this a problem?
This can be a problem for the child as it causes pain and limp and he or she may need treatment for it. However, the long term prognosis is good, meaning we do not expect there to be problems with the foot as the child grows into adulthood.
What are the treatment options?
Treatment for Kohlers is symptomatic, which means that while the child is in pain or limping, we can provide treatment to help with the discomfort. This usually requires immobilization of the foot in either a cast or a boot. Tylenol or Motrin may also be recommended. The pain and limp may come and go and depending on the severity, your doctor will help you decide if treatment is needed.