title: Reconstructive surgery using interference screw fixation for painful accessory navicular in adult athletes.
abstract: OBJECTIVE
  To examine the effectiveness of a new technique for reattaching the posterior tibial tendon (PTT) using a bone tunnel and interference screw after resection of the accessory navicular for painful accessory navicular (type II) in adult athletes.
  
  
  METHODS
  Ten adult athletes (7 male, 3 female; mean age 30 years, range 23-45) underwent reconstruction using a bone tunnel with an interference screw for a painful accessory navicular. All patients complained of pain on the medial aspect of the foot after eversion sprain during sports activities and radiographs revealed type II accessory navicular. Clinical evaluation with the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) and visual analogue scale (VAS) before surgery was compared with that at most recent follow up (mean 30 months, range 24-39).
  
  
  RESULTS
  Mean AOFAS score improved from a preoperative 62.8 ± 2.9 points (range 61-82) to a postoperative 92.1 ± 7.0 points (range 83-100; p < 0.01). Furthermore, mean VAS score improved from a preoperative 92.5 ± 5.4 points (range 85-100) to a postoperative 4.5 ± 3.8 points (range 0-10; p < 0.01). All patients could return to full sports activity at a mean of 14 weeks (range 12-18) after surgery.
  
  
  CONCLUSIONS
  The presented technique reconstructs the bone-tendon interface of the PTT at the primary navicular with sufficient fixation after resection of the accessory navicular, which preserves the strength of the PTT in adult athletes with an intractably painful accessory navicular.
authors: Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo 173-8605, Japan. miyamoto@med.teikyo-u.ac.jp
authors: Wataru
authors: W
authors: Miyamoto
authors: Masato
authors: M
authors: Takao
authors: Kazuaki
authors: K
authors: Yamada
authors: Youichi
authors: Y
authors: Yasui
authors: Takashi
authors: T
authors: Matsushita
mesh_terms: D000328:Adult; D056352:Athletes; D001863:Bone Screws; D005260:Female; D005534:Foot Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013639:Tarsal Bones / Q000002:abnormalities / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D055815:Young Adult