J Korean Foot Ankle Soc.  2016 Jun;20(2):73-77. 10.14193/jkfas.2016.20.2.73.

Short-Term Results of a Modified Kidner Procedure Using a Suture Bridge Technique for Symptomatic Type II Accessory Navicular

• Kim E
• Moon J

• KMID: 2219406
• DOI: http://doi.org/10.14193/jkfas.2016.20.2.73

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular.
MATERIALS AND METHODS
Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score.
RESULTS
The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up.
CONCLUSION
The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

Keyword

Type II accessory navicular; Suture-bridge technique; Modified Kidner

MeSH Terms

Ankle
Follow-Up Studies
Foot
Heel
Humans
Sutures*

Figure

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  Figure 1. Bone marrow edema between navicular proper (asterisk) and accessory navicular (arrow) was found in proton-density weighted turbo spin-echo axial magnetic resonance imaging.

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  Figure 2. Intraoperative photographs. (A) Periosteum-soft tissue flap after excision of Os navicular. (B) Insertion of suture anchor at infero-medial aspect of navicular. (C) Fiber wires pass through periosteum-soft tissue flap. (D) Insertion of PushLock anchor (Arthrex Inc.) at medial aspect of navicular with adequate tension of periosteum-soft tissue flap.

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