Kohler Syndrome

Kohler Syndrome

Kohler Syndrome

Kohler’s syndrome is a rare but documented disease. It is a disruption in the proper development of one of the small bones in the lower part of the legs. The causes for it are not clear; it has been suggested that there is some genetic factor at play, but that has not been proven.

What is Kohler Syndrome?

Kohler’s Syndrome can affect children between the ages of one and ten, but most often appears around the ages of three to seven. It occurs more often in boys than in girls and usually affects only one leg. It happens when the navicular bone, one of the small bones in the foot, does not get enough blood. This causes the bone to degenerate, leading to swelling and pain. It usually resolves itself after a while, and completely heals.

It is not entirely clear what causes Kohler’s syndrome, but it appears that it occurs when the bone does not develop and harden at the right time. (Each bone has its own time to become hard and develop. The process continues until the age of 15-17.) The navicular bone is part of the mechanism of the foot which handles the foot’s movement. When the child grows and the feet need to bear more weight, there is more pressure on the foot and a bone that is not properly developed can be compressed between the other bones. This can lead to Kohler’s syndrome.

A child who has Kohler’s may show the same symptoms as regular foot pain. An examination will find the pain is concentrated in the middle section of the foot, at the base of the arch. At times, the skin around it will become red, and the foot will be swollen. The child will limp while walking or walk awkwardly, putting their weight on the outer side of the foot. An X-ray will show that the bone is not properly developed, bent, compressed, or fractured. Symptoms can remain for several months, but X-rays will still show evidence of the syndrome up to four years later.

Kohler’s syndrome usually heals itself, without treatment and does not leave any long-term damage.

What Is Kohler Syndrome Symptoms

Symptoms of Kohler’s are usually mild. They may be:

  • Swelling
  • Feeling pain in the legs

The pain of Kohler’s comes and goes and may get worse after activities that put pressure on the foot. At times, the children will not want to put their weight on the foot. The arch can become swollen and red. When touched, it can also feel hot and be painful.

It is easy to make a mistake with the symptoms and they may only indicate an inflammation. It is also possible to have Kohler’s without showing any symptoms. The only way to get a correct diagnosis is with an X-ray.

Kohler Syndrome Treatment

 Because Kohler’s is a problem with a bone, it is helpful to take Calcium as well as vitamin D3 which helps the body absorb Calcium properly. You should also take Junior Omega 3, which, besides having a positive effect on the bones, can also help with the swelling around the bone.

What else

An anti-inflammatory pain medication like Ibuprofen (Advil, Motrin) can be taken for swelling. For children with more severe symptoms, such as pain when walking or playing, a doctor will sometimes recommend a cast that will help keep the foot’s shape and take the pressure off it. This is a lightweight cast that can be walked in. At times, such a cast may also help to relieve the symptoms in a shorter period. However, nothing will change the physical aspect of the syndrome and it will last until the bone develops properly. This usually takes about six months but can take up to two years. If the pain persists for an extended period, one should further examine if there may be another illness involved. You should ask a doctor about what to look out for and what to do if symptoms persist for a long time or get worse.

Interesting Facts

Kohler Syndrome

  • The arch of the legs does not develop fully until about two and a half years.
  • 1-2 of every thousand children are born with an extra finger on a hand or foot.

Kohler Syndrome

  • In the United States, the most common shoe sizes sold are 8.5 for women and 10.5 for men.

Kohler Syndrome

  • Toenails grow about one millimeter a month.

Kohler Syndrome

  • In 2008, a 25-year-old woman who was born without hands piloted an airplane by herself!


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