Treatment of Painful Accessory Navicular: A Modification to Simple Excision

Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, mjenkins@vineyard.net

Jason H. Nielson, MD

Bones and Spine Surgery, Sunrise Pediatric Hospital, Las Vegas, Nevada

Claudio Ascani, MD

Clinique Sainte Anne Lumière, Lyon, France

Bryan K. Matanky, MD

private practice, Casa Grande, Arizona

Peter G. Gerbino, MD

Monterey Joint Replacement and Sports Medicine, Monterey, California

An accessory tarsal navicular ossicle may produce pain and tenderness despite conservative treatment modalities. This condition causes pain along the medial arch and limitations of activities. This described modification of the Kidner procedure and simple excision technique keeps the tendon insertion intact while restoring some of the normal biomechanical relationships. In addition, this modification has the theoretical advantage of enhancing dynamic support of the longitudinal arch, and by maintaining the continuity of the posterior tibial tendon, a shorter period of immobilization is required. All patients at the most recent follow-up showed improvement, with 11 of 13 patients having excellent results with long-term follow-up.

Key Words: accessory navicular • pes planus • navicular ossicle • Kidner procedure