Kohler’s Disease primarily affects children, especially boys, between the ages of six and nine. It is a rare bone disorder of the foot and is caused when one’s navicular bone temporarily loses its blood supply. Young girls can also be affected by this condition.
What is Kohler’s Disease?
Kohler’s disease refers to the condition when the blood supply to the navicular bone in the foot is lost spontaneously. This was the description according to doctor Kohler (1908). Osteochondrosis is the spontaneous loss of blood supply to any bone. Later, Dr. Kohler was again associated with other problems of the foot related to osteochondrosis. This defect is called Freiberg’s disease.
Clinical Features and Treatment of Kohler’s Disease
X-ray results help clinicians to identify the presence of this defect. A painful gait or mild pain may be noted around the affected bone. In some instances, mild swelling can also occur. The condition is most prevalent among males and affects only one of the feet. Biopsy of the bone may make diagnosis of the problem unnecessary.
This disease is usually treated by resting the foot, avoiding to put pressure on the affected foot, and taking pain-relieving medicines. Often, in chronic cases, patients are fitted with cam or cast walkers which run from the foot to the knee. This device is usually used for about six weeks after which some patients may be asked to use an arch support for up to half a year. Moderate exercise and physical therapy are also helpful for patients.
Prognosis for Children with Kohler’s Disease
The prognosis for children with this defect is good. In some cases, the condition may persist. However, most cases are resolved in about two years after the first diagnosis. Also, the condition does not usually cause any permanent problem. In rare cases, the damage caused to the foot may last for long.
Reducing the foot’s activity level and using inserts in shoes and other orthotics may serve as treatment measures. Most cases heal after about eight months. In spite of severe fragmentation or the flattening of the navicular bone, follow up activities show that there are no residual degenerative changes in the foot even after thirty years. Thorough diagnosis and proper follow up are recommended for the patients because this condition has been associated with tarsal coalition. Contact us on 03 9077 5915 for further assessment and treatment.