Current concepts of navicular disease

Summary Navicular disease is unlikely to be a single disease. The close anatomical and functional relationships between the navicular bone, collateral sesamoidean ligament, distal sesamoidean impar ligament, deep digital flexor tendon, navicular bursa and distal interphalangeal joint result in the frequent occurrence of combinations of injuries. There are a number of different pathological processes that affect the navicular bone, which probably have different aetiopathogeneses. While there is strong evidence that biomechanical forces may result in failure of functional adaptation and excessive modelling, it is likely that each disease or injury type has a multifactorial cause.