J Korean Foot Ankle Soc.  2020 Jun;24(2):75-80. 10.14193/jkfas.2020.24.2.75.

Results of Kidner Procedure Combined with Medial Displacement Calcaneal Osteotomy for the Symptomatic Accessory Navicular with Hindfoot Valgus

• Park CH

• KMID: 2502913
• DOI: http://doi.org/10.14193/jkfas.2020.24.2.75

Abstract

Purpose
The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus.
Materials and Methods
From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19∼61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated.
Results
The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices.
Conclusion
Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

Keyword

Foot; Accessory navicular bone; Hindfoot valgus; Calcaneal osteotomy

Figure

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  Figure. 1 Intraoperative photograph showed detaching the accessory navicular from the navicular after dissection of periosteum.

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  Figure. 2 Intraoperative photograph showed detached accessory navicular.

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  Figure. 3 Intraoperative photograph showed reattaching the tibialis posterior tendon on its original insertion using the suture anchor.

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  Figure. 4 The anteroposterior weight-bearing radiograph of the foot showed the anterior talo-first metatarsal angle (A) and the talonavicular coverage angle (B).

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  Figure. 5 The lateral weight-bearing radiograph of the foot showed the lateral talo-first metatarsal angle (A) and the calcaneal pitch angle (B).

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  Figure. 6 The hindfoot alignment radiograph showed the hindfoot alignment angle.

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