The conservative treatment for Kohler\'s disease will take several months, but some patients still have flatfoot and persistent pain. From October 2013 to July 2015, 3 children with Kohler\'s disease underwent navicular decompression and micro-circulation reconstruction surgery in our hospital. All the patients have received conservative treatment for more than 3 months and the effect was poor. X-ray showed the bone density of navicular increased significantly. All patients were followed up over 1 year. The 3 patients recovered well. VAS score decreased from 7.0 to 2.6 at 1 month after the operation. The pain symptom disappeared completely on 3 months after surgery. The density of navicular bone recovered to normal. Navicular decompression and micro-circulation reconstruction surgery may quickly improve the ischemic status of navicular bone, alleviate pain symptom and enable patients to resume normal activity as soon as possible.

Kohler\'s disease is characterized by osteochondritis of the navicular bone due to various factors like the lack of blood supply and late ossification of the bone. In particular, it is a disease of the pediatric age group, which has male preponderance. It may present with bony pain unilaterally or, at times, be asymptomatic and diagnosed accidentally. Clinical presentation and radiological investigations are the mainstay of diagnosis. This self-limiting condition requires only symptomatic conservative management. A surgical approach is not yet indicated. One such case of bilateral Kohler\'s disease is presented in this report. Here, we discuss the disease\'s presentation, examination, treatment, and prognosis.

Kohler\'s disease is rare cause of foot pain and limping in the pediatric population. The exact etiology of Kohler\'s disease is unknown. It usually presents as sudden and unexplained foot pain and limping. We report a case of a 5-year-old male who presented to the Pediatric Emergency Department with foot pain and inability to bear weight for two days after overactivity and acute foot injury. The patient was eventually diagnosed with Kohler\'s disease (avascular necrosis of the navicular bone). Although Kohler\'s disease is not very common, it should be considered in the differential diagnosis of foot pain in the pediatric population, as it may prevent unnecessary tests and treatments.