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Köhler Bone Disease

(Köhler's Bone Disease)


Frank Pessler

, MD, PhD, Helmholtz Centre for Infection Research

Last full review/revision Oct 2020| Content last modified Oct 2020
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Köhler bone disease is death (necrosis) of the tarsal navicular bone (a bone at the arch of the foot) due to loss of its blood supply.

Köhler bone disease is caused by a poor blood supply to the tarsal navicular bone. The poor blood supply causes the tarsal navicular bone to die and collapse. Why the blood supply is poor is not known.

Köhler bone disease usually affects children aged 3 to 5 years (more commonly boys) and typically affects only one foot. The foot becomes swollen and painful, and the arch of the foot is tender. Weight bearing and walking increase discomfort, and the child’s manner of walking (gait) is impaired.

Bones of the Foot

Bones of the Foot

Diagnosis of Köhler Bone Disease

  • X-rays

X-rays Plain X-Rays X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more of the foot show that the navicular bone is initially flattened and hardened and later breaks into fragments before healing and hardening back into bone. X-rays comparing the affected side with the unaffected side help assess how far the disease has progressed.

Treatment of Köhler Bone Disease

  • Rest and pain relievers

  • Sometimes a cast

Köhler bone disease rarely lasts more than 2 years. Rest and pain relief are required, and excessive weight bearing must be avoided. This disease usually resolves without treatment and without any long-term consequences. In severe cases, having the child wear a below-knee walking plaster cast A dislocation is complete separation of the bones that form a joint. In subluxation, the bones in a joint are partly out of position. Often, a dislocated joint remains dislocated until it is... read more for a few weeks may help. Crutches are often not needed with a walking cast.

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