title: Simple excision vs the Kidner procedure for type 2 accessory navicular associated with flatfoot in pediatric population.
abstract: BACKGROUND
  Recently, many studies have argued against the Kidner procedure and its several modifications, with the accessory navicular considered an irritant rather than a hindrance to foot function, and simple excision has been advocated. We designed this prospective, comparative study of simple excision and the Kidner procedure in children and adolescents with flatfoot and evaluated functional and radiographic outcomes.
  
  
  METHODS
  From February 2004 to March 2009, we followed 50 consecutive feet of symptomatic type 2 accessory navicular. Simple excision and the Kidner procedure were performed in 25 feet each, respectively. The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Scale, the visual analogue scale (VAS), and the talo-first metatarsal, talocalcaneal, and calcaneal pitch angles were evaluated preoperatively and postoperatively for a minimum of 3 years. Patient satisfaction was assessed.
  
  
  RESULTS
  The preoperative AOFAS midfoot scale and VAS of each group were improved at final follow-up. The talo-first metatarsal and talocalcaneal angles were not significantly different pre- and postoperatively. However, the calcaneal pitch angle of both groups was improved at the final follow-up. At the final follow-up, we observed no significant differences between the 2 groups in the AOFAS midfoot scale, the VAS, and the talo-first metatarsal, talocalcaneal, and calcaneal pitch angles. The satisfaction frequencies were 86% and 82% in groups 1 and 2, respectively.
  
  
  CONCLUSIONS
  We found that in children and adolescents with accessory navicular and flatfoot, simple excision and the Kidner procedure both gave satisfactory results and both minimally restored the medial longitudinal arch similarly.
  
  
  METHODS
  Level II, prospective therapeutic study.
authors: Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, South Korea.
authors: Soo-Min
authors: SM
authors: Cha
authors: Hyun-Dae
authors: HD
authors: Shin
authors: Kyung-Cheon
authors: KC
authors: Kim
authors: Jeong-Kil
authors: JK
authors: Lee
mesh_terms: D000293:Adolescent; D002111:Calcaneus / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D005413:Flatfoot / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011859:Radiography; D013639:Tarsal Bones / Q000002:abnormalities* / Q000601:surgery*; D013710:Tendons / Q000601:surgery*