2017 ISAKOS Biennial Congress ePoster #117
The Excision of Accessory Navicular with Reconstruction of Posterior Tibial Tendon Insertion on Navicular for the Flatfoot Related with Accessory Navicular
Zhang Hongxin, PhD, Chongqing, Chongqing CHINA
Kanglai Tang, MD, PhD, Prof., Chongqing, Chongqing CHINA
Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University / COA National Training Center for Foot and Ankle Surgeon, Chongqing, Chongqing, CHINA
FDA Status Cleared
Summary
To introduce excision of accessory navicular with reconstruction of posterior tibial tendon insertion on navicular for the flatfoot related with accessory navicular, and evaluated its clinical outcomes.
ePosters will be available shortly before Congress
Abstract
Objective
To introduce excision of accessory navicular with reconstruction of posterior tibial tendon insertion on navicular for the flatfoot related with accessory navicular, and evaluated its clinical outcomes. Methods From May 2006 to June 2010, 29 patients (36 feet) of flatfoot related with accessory navicular, which included 13 male and 16 female, 22 unilateral flatfeet and 7 bilateral flatfeet, with a failure of conservative treatment for more than 6 months, received excision of accessory navicular with reconstruction of posterior tibial tendon insertion on navicular. All patients were followed-up at pre-op, 6 weeks, 3 months, 6 months, 12 months and every 6 months after surgery by clinical exam and radiology. All patients were evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-midfoot scores. The arch height, calcaneus inclination angle (CI), talocalcaneal angle (TC), talar first metatarsal angle (TMT) was measured on the lateral weight-bearing radiograph. The talocalcaneal angle (TC), talar first metatarsal angle (TMT) on the AP view of the weight-bearing radiograph. Results 26 patients (32 feet) were followed up with a mean 18.9 months (ranged from 6 to 54 months). All patients were satisfied with their clinical results without any pain 6 months after surgery. There was no wound infection or nerve injury. The average AOFAS ankle-midfoot score improved from 47.6±7.0 preoperatively to 90.5±2.3 at the last follow-up (P <0.01). Radiographically, all parameters were statistically significant between pre-operation and the last follow-up (p < 0.001), including the arch height from 26.0±1.4mm to 34.4±2.2mm, CI from 13.3°±1.4°to 22.0°±2.8°, TC from 47.5°±3.1°to 37.4°±3.7°and TMT from 9.9°±2.1°to 3.7°±1.0°on the lateral weight-bearing view; TC from 36.5°±2.6°to 22.3°±4.2°and TMT 10.5°±2.1°to 3.8°±1.1°on the AP weight-bearing view. Conclusion The excision of accessory navicular with reconstruction of posterior tibial tendon insertion on navicular is a good choice for the treatment of accessory navicular related flatfoot, with excellent clinical outcomes, correction of deformity, without any complication.
Keywords: Accessory Navicular, Flatfoot, Posterior Tibial Tendon, Reconstruction.