Kidner Procedure for Symptomatic Accessory Navicular and Its Relation to Pes Planus

Abstract

The role of relocation of tibialis posterior tendon insertion in the treatment of symptomatic accessory navicular and its relation to the pes planus was studied in 28 patients with symptomatic accessory navicular. Two hundred non-affected individuals were used as control. The calcaneal pitch angle measured radiographically, was used as an indicator of pes planus. All patients had had an excision of the accessory navicular and relocation of the tibialis posterior tendon insertion (Kidner procedure). The average follow-up was 3.2 years. The results were good in 27 patients, and fair in 1 patient, and there were no poor results. Most of the patients demonstrated that the pain and the fatigue signs of the foot and the leg have been improved. Only 3 of 25 patients clinically showed an improvement of the medial longitudinal arch. The calcaneal pitch angle in patients with symptomatic accessory navicular was significantly (14.8 degrees) lower than that in normal subjects (21.4 degrees). An association of pes planus and symptomatic accessory navicular was shown. The Kidner procedure gave good results in the relief of pain and fatigue in patients with symptomatic accessory navicular. The procedure did not significantly restore the height of the medial arch.

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

“…5,7-10,12 Yet none of these variations have been successful in addressing the planovalgus deformity, raising questions about the role of the PTT in supporting the arch. 1,4,6,11,13,14 Arthroereisis has been used for quite a long time in children with great results. It has been shown to correct flexible flatfeet and restore the medial longitudinal arch.…”

“…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. 1,4,6,11,13,14 Currently accepted surgical management of planovalgus deformity involves various soft tissue and bony procedures. Subtalar arthroereisis should be considered part of that group of procedures.…”

Magnetic Resonance Imaging in Adolescent Painful Flexible Flatfoot

“…8,20 However, the association between an accessory navicular and flexible flatfoot symptom is not clear. An accessory navicular is found in up to 16% of asymptomatic subjects, 19 and many patients with painful accessory navicular have normal foot arches. 8 The current study shows that the disease process is not confined to the accessory navicular synchondrosis.…”

An unusual cause of medial foot pain: The cornuate navicular

“…It consists of the resection of the part projecting from the navicular bone with reintegration of the tendon of the tibialis posterior muscle in a more plantar position. In addition, pes planovalgus deformities need to be addressed concomitantly (6,7).…”