Outcome of Fusion of a Painful Accessory Navicular to the Primary Navicular

Abstract

When conservative treatment fails to relieve pain in a type II accessory navicular, fusion of the accessory navicular to the navicular may successfully relieve pain without disrupting the tibialis posterior tendon insertion.

Midterm Outcome of Modified Kidner Procedure

“…Recently, screw osteosynthesis of an accessory navicular which is large enough to accept small screws achieved bone union in 80 to 82%. 5,15 According to Scott et al, in 30% of feet treated with a modified Kinder procedure, there was radiographic evidence of progressive longitudinal arch loss, while AOFAS scores were found to improve from 52 to 80 compared with improvement from 50 to 93 in fusion cases at a mean followup of 48 months. 15 However, for screw fixation or percutaneous drilling, the diameter of the accessory navicular should be at least 2 to 3 times wider than the screw or drill bit necessary for the procedure, 5,1514 and these procedures have the risk of accessory navicular fracture.…”

Combined Modified Kidner Procedure With Subtalar Arthroereisis for the Correction of Painful Accessory Navicular Associated With Planovalgus Deformity

“…1 Patients who fail nonoperative measures should be considered for operative intervention. Accepted surgical treatments for such patients include simple excision of the accessory bone from within the PTT, screw fixation of the accessory bone to the native navicular, 7,8 or excision with detachment, advancement and reattachment of the PTT, also known as the Kidner procedure. 1,[5][6][7][9][10][11] The Kidner procedure was first described in 1929 by Dr Frederick Clinton Kidner and has had great success in alleviating pain in patients with a symptomatic accessory navicular recalcitrant to nonoperative treatments.…”

“…Accepted surgical treatments for such patients include simple excision of the accessory bone from within the PTT, screw fixation of the accessory bone to the native navicular, 7,8 or excision with detachment, advancement and reattachment of the PTT, also known as the Kidner procedure. 1,[5][6][7][9][10][11] The Kidner procedure was first described in 1929 by Dr Frederick Clinton Kidner and has had great success in alleviating pain in patients with a symptomatic accessory navicular recalcitrant to nonoperative treatments. 5,9,10,12 However, it has been shown that the Kidner procedure alone fails to correct the flattening of the arch, except in very young children where correction was attributed to growth rather than the procedure itself.…”

Acquired Flat Foot Deformity: Postoperative Imaging

“…[24][25][26] Arthrodesis of an accessory navicular to the main body of the navicular has also been described in larger ossicles using one or two cannulated screws. [27][28][29]…”

“…Several studies have assessed arthrodesis of a type 2 accessory navicular to the medial process of the navicular. [27][28][29] The most common significant complication is nonunion/loosening of screws, requiring further surgery to excise the ossicle. 28,29 Chung et al reported that 6 of 22 feet had loosening of the screw(s).…”