Kohler’s Disease (Navicular Avascular Necrosis in Children)


Kohler’s disease is a rare condition in which the bone in the arch of the foot becomes inflamed. Kohler’s disease usually affects children between the ages of three and five. It occurs more commonly in boys than in girls, and is often unilateral, affecting one foot. Bone tissue deteriorates due to an interruption of blood supply leading the bone into breakage into tiny fragments before healing and hardening. As a result, foot becomes swollen and painful, and the arch of the foot is tender.

How did I get this?

What causes avascular necrosis of the navicular bone is unclear, but a delayed ossification or hardening of bone may be partially responsible.

What can I do about it?

  • Rest and avoid excessive weight bearing.
  • Short term non-steroidal anti-inflammatory drugs (e.g.ibuprofen) for pain control.

What help can I get for this?

  • Podiatrist may prescribe soft arch supports or medial heel wedge, and removable cam walker.

When will it get better?

Kohler’s disease is self-limiting, meaning that it usually resolves on its own, without any long-term consequences. In children who are treated with rest and support, and who avoid putting excessive weight on the affected foot, the disease rarely lasts more than two years. Almost all patients eventually recover excellent function.