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February 1928


Author Affiliations

From the Orthopaedic Clinic of the Stanford University Medical School.

Arch Surg. 1928;16(2):560-568. doi:10.1001/archsurg.1928.01140020111005

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Köhler's disease is a peculiar condition in which the tarsal navicular bone is abnormal in shape, size and density. It was first described by Köhler of Wiesbaden in 1908. It affects boys more often than girls in the proportion of about two to one. The age limits are from 1 to 10 years, the great majority of cases occurring in patients between the ages of 3 and 7. The disease is characterized by pain which is made worse by exercise. Sensitiveness is also present over the navicular bone, possibly accompanied by redness and swelling. The patient limps, and may walk on the lateral border of his foot. The symptoms persist for a longer or shorter time, and then disappear. Complete recovery always takes place with any treatment.

The diagnosis is made with the roentgen rays. The bone nucleus of the navicular bone is usually narrow, that is, the distance from

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