The accessory navicular and its association with flatfoot

Publication date: Available online 8 February 2020Source: Fuß & SprunggelenkAuthor(s): Stefan Rammelt, Andrew K. SandsAbstractBackgroundThe accessory navicular (os tibiale externum, prehallux) is a frequent skeletal variation. It may become symptomatic and is reported to be associated with flatfoot in children and adults.MethodsWe conducted an extensive review of the literature and reviewed the experience from two centers of foot and ankle surgery in Germany and the United States.Results and conclusionsThe majority of accessory navicular ossicles is asymptomatic. Symptoms may arise from local pressure in shoewear, loosening of the connection to the navicular body as well as irritation and functional elongation of the tibialis posterior tendon (PTT). A symptomatic accessory navicular is frequently associated with flexible flatfoot. Resection of the ossicle with debridement of the medial aspect of the navicular and attachment of the PTT to the navicular body (modified Kidner procedure) leads to good and excellent results in about 80% of patients and some heightening of the arch mainly in adolescents. In more severe deformities, augmentation of the Kidner technique with fusion of the accessory navicular to the navicular proper, transfer of the flexor digitorum longus tendon, arthroereisis, osteotomies, calf gastrocnemius release and midfoot fusions have lead to favorable results in smaller series.ZusammenfassungHintergrundDas Os tibiale externum (akzessorisches Os naviculare, P...
Source: Fuss and Sprunggelenk - Category: Podiatry Source Type: research