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Comparison of Clinical Outcome of Excision versus Osteosynthesis in Type II Accessory Navicular  

Lee, Jong-Seok (Department of Orthopedic Surgery, Hanil General Hospital)
Youn, Hyun-Kook (Daegu W Hospital)
Choi, Woo-Jin (Department of Orthopedic Surgery, Yonsei University College of Medicine)
Lee, Jin-Woo (Department of Orthopedic Surgery, Yonsei University College of Medicine)
Publication Information
Journal of Korean Foot and Ankle Society / v.15, no.2, 2011 , pp. 72-78 More about this Journal
Abstract
Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.
Keywords
Accessory navicular; Excision; Osteosynthesis;
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1 Tomita F, Yasuda K, Mikami S, Sakai T, Yamazaki S, Tohyama H. Comparison of intraosseous graft healing between the doubled flexor tendon graft and the bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction. Arthroscopy. 2001;17:461-76.   DOI   ScienceOn
2 Park MJ, Lee MC, Seong SC. A comparative study of the healing of tendon autograft and tendon-bone autograft using patellar tendon in rabbits. Int Orthop. 2001;25:35-9.   DOI   ScienceOn
3 Ostrum RF, Chao EYS, Bassett CAL, et al. Bone injury, regeneration and repair. 1st ed. In: Simon SR, ed. Orthopaedic Basic Science. Columbus, OH: American Academy of Orthopaedic Surgeons; 1994. 277-323.
4 Ray S, Goldberg VM. Surgical treatment of the accessory navicular. Clin Orthop Relat Res. 1983;177:61-6.
5 Sullivan JA, Miller WA. The relationship of the accessory navicular to the development of the flat foot. Clin Orthop Relat Res. 1979;144:233-7.
6 Jasiewickz B, Potaczek T, Kacki W, Tesiorowski M, Lipik E. Results of simple excision technique in the surgical treatment of symtomatic accessory navicular bones. Foot Ankle Surg. 2008;14:57-61.   DOI   ScienceOn
7 Kopp FJ, Marcus RE. Clinical outcome of surgical treatment of the symptomatic accessory navicular. Foot Ankle Int. 2004;25:27-30.   DOI
8 Chung JW, Chu IT. Outcome of fusion of a painful accessory navicular to the primary navicular. Foot Ankle Int. 2009;30:106-9.   DOI   ScienceOn
9 Macnicol MF, Voutsinas S. Surgical treatment of the symptomatic accessory navicular. J Bone Joint Surg Br. 1984; 66:218-26.
10 Tan SM, Chin TW, Mitra AK, Tan SK. Surgical treatment of symptomatic accessory navicular. Ann Acad Med Singapore. 1995;24:379-81.
11 Scott AT, Sabesan VJ, Saluta JR, Wilson MA, Easley ME. Fusion versus excision of the symptomatic Type II accessory navicular: a prospective study. Foot Ankle Int. 2009;30: 10-5.   DOI   ScienceOn
12 Kanatli U, Yetkin H, Yalcin N. The relationship between accessory navicular and medial longitudinal arch: evaluation with a plantar pressure distribution measurement system. Foot Ankle Int. 2003;24:486-9.   DOI
13 Zadek I. The significance of the accessory tarsal scaphoid. J Bone Joint Surg Am. 1926;8:618-26.
14 Kidner FC. The prehallux in relation to flatfoot. JAMA. 1933;101:1539-42.   DOI
15 Grana WA, Egle DM, Mahnken R, Goodhart CW. An analysis of autograft fixation after anterior cruciate ligament reconstruction in a rabbit model. Am J Sports Med. 1994; 22:344-51.   DOI   ScienceOn
16 O'Rahilly R. A survey of carpal and tarsal anomalies. J Bone Joint Surg Am. 1953;35:626-42.   DOI
17 Panni AS, Milano G, Lucania L, Fabbriciani C. Graft healing after anterior cruciate ligament reconstruction in rabbits. Clin Orthop Relat Res. 1997;343:203-12.
18 Grogan DP, Gasser SI, Ogden JA. The painful accessory navicular: a clinical and histopathological study. Foot Ankle. 1989;10:164-9.   DOI
19 Kiter E, Gunal I, Turgut A, Kose N. Evaluation of simple excision in the treatment of symptomatic accessory navicular associated with flat feet. J Orthop Sci. 2000;5: 333-5.   DOI   ScienceOn
20 Romanowski CA, Barrington NA. The accessory navicular-- an important cause of medial foot pain. Clin Radiol. 1992;46:261-4.   DOI   ScienceOn
21 Ugolini PA, Raikin SM. The accessory navicular. Foot Ankle Clin. 2004;9:165-80.   DOI   ScienceOn
22 Demeyere N, De Maeseneer M, Osteaux M. Quiz case. Symptomatic type II accessory navicular. Eur J Radiol. 2001;37:60-3.   DOI   ScienceOn
23 Issever AS, Minden K, Eshed I, Hermann KG. Accessory navicular bone: when ankle pain does not originate from the ankle. Clin Rheumatol. 2007;26:2143-4.   DOI   ScienceOn
24 Miller TT, Staron RB, Feldman F, Parisien M, Glucksman WJ, Gandolfo LH. The symptomatic accessory tarsal navicular bone: assessment with MR imaging. Radiology. 1995;195:849-53.   DOI
25 Geist ES. The accessory scaphoid bone. J Bone Joint Surg AM. 1925;7:570-4.
26 Kidner FC. The prehallux (accessory scaphoid) in its relation to flat-foot. J Bone Joint Surg Am. 1929;11:831-7.
27 Bennett GL, Weiner DS, Leighley B. Surgical treatment of symptomatic accessory tarsal navicular. J Pediatr Orthop. 1990;10:445-9.   DOI
28 Malicky ES, Levine DS, Sangeorzan BJ. Modification of the Kidner procedure with fusion of the primary and accessory navicular bones. Foot Ankle Int. 1999;20:53-4.   DOI   ScienceOn
29 Lawson JP, Ogden JA, Sella E, Barwick KW. The painful accessory navicular. Skeletal Radiol. 1984;12:250-62.   DOI   ScienceOn
30 Bareither DJ, Muehleman CM, Feldman NJ. Os tibiale externum or sesamoid in the tendon of tibialis posterior. J Foot Ankle Surg. 1995;34:429-34.   DOI   ScienceOn
31 Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF. Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog. J Bone Joint Surg Am. 1993; 75:1795-803.   DOI