Kidner procedure for symptomatic accessory navicular and its relation to pes planus

The role of relocation of tibialis posterior tendon insertion in the treatment of symptomatic accessory navicular and its relation to the pes planus was studied in 28 patients with symptomatic accessory navicular. Two hundred non-affected individuals were used as control. The calcaneal pitch angle measured radiographically, was used as an indicator of pes planus. All patients had had an excision of the accessory navicular and relocation of the tibialis posterior tendon insertion (Kidner procedure). The average follow-up was 3.2 years. The results were good in 27 patients, and fair in 1 patient, and there were no poor results. Most of the patients demonstrated that the pain and the fatigue signs of the foot and the leg have been improved. Only 3 of 25 patients clinically showed an improvement of the medial longitudinal arch. The calcaneal pitch angle in patients with symptomatic accessory navicular was significantly (14.8 degrees) lower than that in normal subjects (21.4 degrees). An association of pes planus and symptomatic accessory navicular was shown. The Kidner procedure gave good results in the relief of pain and fatigue in patients with symptomatic accessory navicular. The procedure did not significantly restore the height of the medial arch.