Medial column reinforcement for the correction of flatfoot deformity with accessory navicular bone

This study aimed to evaluate the clinical effects of reinforcement of the medial column in the treatment of flatfoot deformity with accessory navicular bone.

A retrospective analysis of 32 patients (46 feet) of flatfoot deformity with accessory navicular bone were reviewed. All patients underwent the reinforcement of their medial column in the midfoot, mainly including spring ligament repair, posterior tibial tendon reconstruction, and cotton osteotomy. Clinical evaluation adopted American Orthopaedic Foot and Ankle Society (AOFAS) score and pain visual analogue scale (VAS) was used to evaluate foot function and pain. Radiographic evaluation was performed, and Meary's angle, calcaneal pitch angle, talonavicular coverage angle (TCA), talar 2th metatarsal angle (T2MT) and calcaneal valgus angle (CVA) were measured.

All patients were followed up for an average duration of 24.3±3.6 months. At the final follow-up, the patient's foot pain was relieved and the foot deformity was improved. The data indicated that the mean functional AOFAS score was significantly improved and the mean VAS score was significantly decreased postoperatively at final follow-up. Additionally, Meary's angle, TCA, T2MT and CVA were all significantly decreased, and calcaneal pitch angle was significantly increased after surgery.

We found that reinforcement of the medial column can effectively maintain medial longitudinal arch, correct flatfoot deformity with accessory navicular bone.