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検証済み

Kantaphong Thongrong

9年の経験

Board-certified physiatrist (Diplomate of the Thai Board of Rehabilitation Medicine, 2023). Head of Rehabilitation at King Mongkut Chaokhunthahan Hospital. CEO and Founder of PYONG Rehabilitation Group since 2023.

Clinical focus: neurorehabilitation, geriatric rehabilitation, and chronic pain. Uses robotics and wearable exoskeleton gait training. Performs ultrasound-guided procedures and advanced laser and radiofrequency therapies.

Principal Investigator of a pilot randomized controlled trial on wearable exoskeleton gait training in subacute stroke. Presented to the Royal College of Physiatrists of Thailand in 2023. Instructor at KMITL since 2020.

Completed Rehabilitation Medicine residency at Chulalongkorn University in 2023. Earned an MD in 2017. Runs a public health platform with over 100,000 followers. Hosted PYONG SUMMIT in 2024 with over 200 attendees. Honors include nominee for Quality Person of the Year 2025 and First Prize in the Ananda Mahidol Pin Design in 2016.

検証済み

Pradab Pradasuk

24年の経験

Dr. Pradab Pradasuk is an orthopedic surgeon with 24 years of experience at Navamin9 Hospital in Bangkok. He consults in English and Thai.

His practice focuses on arthroscopy and knee reconstruction. This includes ACL surgery, meniscectomy, arthroplasty, and joint replacement. He treats shoulder disorders, including rotator cuff tears. He manages ankle and foot conditions, including arthrodesis, joint replacement, Achilles tendon repair, and toe or foot reconstruction. He performs fracture surgery of the forearm, pelvis, and spine. Spine procedures include endoscopic discectomy, decompression, fusion with instrumentation, and spinal cord stimulation (SCS). He provides limb prosthetics and orthotics. He provides orthopedic rehabilitation, including Re-Step. Diagnostic support includes MRI, CT, and chest X-ray.

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更新済み: 05/28/2025
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タイでの副舟状骨治療に関するFAQ

これらのFAQはBookimedを通じて医療支援を求める実際の患者からのものです。回答は経験豊富な医療コーディネーターと信頼できるクリニック代表者が行います。

What is an accessory navicular bone and why does it cause pain?

An accessory navicular bone is an extra ossicle or cartilage piece on the inner foot. Approximately 10% to 14% of people have this congenital condition. Pain occurs when the posterior tibialis tendon pulls on the bone. This traction creates inflammation and midfoot discomfort during activities.

  • Cause of pain: The posterior tibialis tendon attaches to this extra bone instead of the main navicular.
  • Mechanical irritation: Footwear rubbing against the bony prominence causes redness, swelling, and localized tenderness.
  • Associated conditions: Patients with flat feet often experience higher stress on this secondary bone structure.
  • Symptom triggers: Physical activity, growth spurts, or foot injuries can turn a silent bone symptomatic.

Bookimed Expert Insight: While many general hospitals treat foot pain, specialized centers like KDMS Specialized Orthopedic Hospital in Bangkok offer refined outcomes. Since it is Thailand’s first dedicated orthopedic hospital, they combine specialized co-treatment spaces with robotic-assisted surgery. This focused environment is ideal for complex foot reconstructions where precision impacts long-term arch stability.

Patient Consensus: Patients note that pain often stays hidden for years until a specific sports injury or a growth spurt. They emphasize finding shoes with a wider toe box to stop the inner bump from rubbing.

What are the common symptoms of accessory navicular syndrome?

Accessory navicular syndrome presents as an extra bone or cartilage piece on the inner foot that causes inflammation. Primary symptoms include a visible protrusion, arch pain, and localized swelling. Symptoms often emerge during adolescence or after injuries. Footwear irritation and difficulty with weight-bearing activities are also common indicators.

  • Visible prominence: A hard, palpable bump appears on the inner foot above the arch.
  • Activity-related pain: Throbbing or aching in the midfoot worsens during running or long walks.
  • Inflammation signs: Redness, warmth, and localized swelling occur over the extra bony structure.
  • Footwear intolerance: Narrow shoes cause friction, leading to blisters or sharp pain at the site.

Bookimed Expert Insight: Thai orthopedic centers like KDMS Specialized Orthopedic Hospital utilize advanced imaging like MRI to distinguish this from flat feet. Specialist Dr. Pradab Pradasuk at Navamin 9 Hospital brings over 20 years of experience to foot reconstructions. His expertise helps identify if the posterior tibial tendon is also affected before recommending surgery.

Patient Consensus: Patients mention the pain often fluctuates, flaring up after exercise but feeling better with rest. Many note that the bump is often mistaken for a simple bruise until the pain becomes persistent.

What non-surgical treatments are used first in Thailand?

Thai orthopedic specialists prioritize conservative management for accessory navicular bone pain using immobilization and supportive care. First-line treatments include custom orthotics, arch supports, and physical therapy to stabilize the posterior tibial tendon. For acute flare-ups, clinicians often prescribe non-steroidal anti-inflammatory drugs and immobilization boots.

  • Arch supports: Custom inserts relieve pressure on the navicular bone and support the arch.
  • Activity modification: Reducing high-impact sports minimizes irritation of the posterior tibial tendon and bone.
  • Immobilization: Walking boots or braces stabilize the foot during periods of significant inflammation.
  • Ultrasound therapy: Ultrasound-guided interventions and laser therapy help manage chronic pain and inflammation.

Bookimed Expert Insight: Thai orthopedic centers, such as KDMS Specialized Orthopedic Hospital, function as dedicated facilities solely for bone health. Data shows these clinics integrate advanced physical therapy with the latest robotic gait training early in the recovery process. This focus on specialized orthopedic environments ensures that conservative treatments are monitored by sub-specialized staff rather than generalists.

Patient Consensus: Patients note that supportive footwear and custom arch inserts provide the most significant daily relief. Many emphasize that returning to intensive exercise too quickly often causes pain to resurface after initial improvement.

When is surgery recommended for the accessory navicular bone?

Surgery for an accessory navicular bone is recommended when conservative treatments fail to resolve chronic pain. Specialists typically advise intervention after 3 to 6 months of non-surgical care. Common indicators include persistent swelling and difficulty wearing shoes due to a prominent bony protrusion.

  • Nonsurgical failure: Persistent symptoms despite using custom orthotics, physiotherapy, or immobilization.
  • Functional impact: Ongoing pain that limits walking, running, or standing for long periods.
  • Tendon involvement: Chronic inflammation of the posterior tibial tendon affecting foot arch stability.
  • Bony impingement: Physical irritation or redness caused by the extra bone rubbing against footwear.

Bookimed Expert Insight: Thai orthopedic centers like KDMS Specialized Orthopedic Hospital offer specialized co-treatment spaces for recovery. Patients seeking surgery should prioritize clinics with on-site MRI and CT capabilities. This ensures precise mapping of the extra bone before the Kidner procedure begins. Specialists like Dr. Pradab Pradasuk at Navamin 9 Hospital manage these complex ankle and foot conditions.

Patient Consensus: Patients note that surgical intervention becomes necessary when inflammation leads to irreversible discomfort. Many emphasize starting with orthotics and physical therapy before deciding on surgery.

What does the Kidner-type surgery involve?

Kidner-type surgery involves removing a symptomatic accessory navicular bone and reattaching the posterior tibial tendon. Thai orthopedic surgeons use small incisions to access the bone. This procedure restores proper foot mechanics and relieves chronic inner arch pain. Most patients recover fully within six weeks.

  • Bone excision: Surgeons remove the abnormal accessory bone and any inflamed cartilage.
  • Tendon reattachment: The posterior tibial tendon is repositioned and secured to the main bone.
  • Soft tissue repair: Removal of inflamed bursae or extra tissue helps reduce localized pain.
  • Post-operative care: Patients typically use protective boots and crutches during early recovery.

Bookimed Expert Insight: Thailand offers specialized care through facilities like KDMS Specialized Orthopedic Hospital in Bangkok. This dedicated hospital focuses exclusively on orthopedics and sports medicine. Selecting centers with high specialized patient volumes often ensures surgeons utilize the latest minimally invasive techniques. Surgeons like Dr. Pradab Pradasuk bring over 20 years of experience to complex foot reconstructions.

Patient Consensus: Patients note that recovery timelines often feel longer than expected. Many emphasize the need to clarify if surgeons will add flatfoot correction during the procedure.

What is the expected recovery timeline after surgery?

Recovery after accessory navicular bone surgery in Thailand typically takes 6 to 12 weeks for daily activities. Full healing for high-impact sports requires 3 to 6 months. Patients spend several weeks non-weight-bearing following the procedure. Specialized orthopedic centers in Bangkok utilize minimally invasive techniques to reduce recovery time.

  • Weight-bearing status: Patients remain non-weight-bearing for several weeks to ensure bone and tendon healing.
  • Daily activities: Most patients return to basic routine tasks within 6 to 12 weeks post-surgery.
  • Athletic return: Sports and high-impact activities typically require 3 to 6 months of recovery.
  • Surgical approach: Minimally invasive methods available in Bangkok centers lead to smaller incisions and less pain.

Bookimed Expert Insight: Thailand's specialized orthopedic hospitals, such as KDMS, focus exclusively on musculoskeletal health. These facilities use robotic-assisted technology and specialized co-treatment spaces to streamline rehabilitation. Recovery timelines often depend on whether the surgeon performs tendon reattachment or flatfoot correction alongside bone removal. Choosing an orthopedic-only hospital ensures access to doctors like Dr. Pradab Pradasuk, who has over 20 years of experience in complex foot reconstruction.

Patient Consensus: Patients note that pain levels improve much faster than mobility, requiring patience during the non-weight-bearing phase. Many emphasize the importance of staying in Bangkok longer for follow-up wound checks before flying home.

Can an accessory navicular bone resolve spontaneously without treatment?

An accessory navicular bone does not resolve or disappear spontaneously without treatment. This congenital anatomical variation is a permanent extra bone or cartilage stage. While the bone remains persistent, associated pain and inflammation can often subside with conservative medical management and specialized rehabilitation.

  • Anatomical persistence: The extra bone structure never physically dissolves or reabsorbs into the body naturally.
  • Symptom management: Pain and swelling may resolve through rest, activity modification, or specialized footwear changes.
  • Nonoperative care: Doctors utilize custom orthotics, medial heel wedges, or casting to reduce tendon irritation.
  • Surgical removal: Persistent pain failing conservative care requires surgical excision of the extra bone fragment.

Bookimed Expert Insight: Thai orthopedic centers offer a unique advantage by integrating advanced diagnostics like standing CT scans with comprehensive rehabilitation. Dr. Pradab Pradasuk at Navamin 9 Hospital brings over 20 years of expertise in ankle conditions and limb orthotics. This combination ensures that patients receive precise structural assessments. Specialized facilities like KDMS Hospital focus exclusively on orthopedics to provide targeted recovery protocols.

Patient Consensus: Patients note that while the pain may temporarily disappear with rest, flare-ups often return during sports or long periods of standing. Many find that small accessory bones can cause more significant discomfort than larger ones.

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