Köhler's Disease
A self limiting avasulcar necrosis of the navicular usually unilateral and affects children, most often boys.  Onset is at age 4 in boys and age 5 in girls.  The navicular is subjected to repetitive compressive forces during weight bearing.  Since the navicular is last bone in foot to ossify, delayed ossification appears to make the navicular more vulnerable to compressive damage.  These compressive forces can occlude the vessels of the soft ossification center rendering it avascular.


Custom orthotics are indicated for best results of both long term treatment prognosis and immediate pain relief.  This orthotic will support the longitudinal arch of the foot and decrease localized pressure to the navicular.  This relief of pressure will restore vascular supply and prevent necrosis.