Morbus Köhler 1
Morbus Köhler 1 involves the necrosis of bone tissue due to insufficient blood supply, specifically in the navicular bone on the inside of the foot. This small foot bone is situated on the inside of the foot, just in front of the ankle.
The cause of insufficient blood supply is often unknown. Morbus Köhler 1 occurs in children aged between three and eight years and is more common in boys than in girls. To prevent symptoms later in life, it is important that this condition is recognised early and treated by a podiatrist.
The navicular bone ossifies relatively late, usually in the third or fourth year of life. In boys, this may not occur until the fifth year. Until this bone has ossified, it remains a weak spot amongst the other tarsal bones. Furthermore, this bone is the highest in the midfoot, meaning that when the foot is under load, significant compressive forces are generated at the site of this bone. To reduce these compressive forces, there are podiatric insoles are fitted, by providing optimal support for the boat-shaped foot.
Morbus Köhler 1 and Morbus Köhler 2 are similar conditions, but affect a different bone in the foot.
Symptoms of Köhler’s disease 1
- Pain and/or swelling on the inside of the foot
- Pain when touching the navicular bone
- Because of the pain, the child often limps to protect their foot.
- Symptoms can become so severe that walking is almost impossible
Treatment by the podiatrist
There is no treatment for Köhler’s disease; it resolves spontaneously within one and a half to three years without any residual symptoms.
To support the arch of the foot, you can podiatry insoles be manufactured. This will help to alleviate symptoms. Resting and, if necessary, walking with crutches can help the affected foot to become pain-free again. In addition, well-fitting shoes are very important; they must not be too tight and must provide sufficient stability. In some cases, the foot may need to be put in a plaster cast to allow it to rest even more.
The result
Depending on the severity of the condition and the course of treatment followed, the symptoms will have disappeared after approximately one year. Once the foot is pain-free, weight may gradually be placed on it again.
