title: Surgical treatment of symptomatic accessory navicular in children and adolescents.
abstract: Although an accessory navicular (AN) is present in approximately 10% of the population, it rarely is symptomatic, and few cases necessitate operative intervention. When symptoms require surgical treatment, excision of the AN, with or without advancement of the posterior tibial tendon, usually is successful. We reviewed our records to evaluate the outcomes and complications of surgical treatment of AN. Retrospective chart review identified patients younger than 18 who were treated surgically for a painful AN between 1991 and 2012. Medical records and digital images were reviewed to determine demographic information, duration of symptoms before surgery, type of AN, presence of flatfoot deformity, type of surgery, length of follow-up, outcomes, and complications. Twenty-seven patients (32 feet) had either isolated excision (14 feet) or excision plus tendon advancement (18 feet). Overall, 28 (87.5%) of feet had excellent or good functional outcomes. There was no significant difference in outcomes between the 2 procedures, though there was a trend toward more complications and more reoperations after tendon advancement.
authors.affiliation: Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN. juanpretell@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Pretell-Mazzini
authors.forename: Robert F
authors.initials: RF
authors.lastname: Murphy
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Sawyer
authors.forename: David D
authors.initials: DD
authors.lastname: Spence
authors.forename: William C
authors.initials: WC
authors.lastname: Warner
authors.forename: James H
authors.initials: JH
authors.lastname: Beaty
authors.forename: Alice
authors.initials: A
authors.lastname: Moisan
authors.forename: Derek M
authors.initials: DM
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging / Q000601:surgery*; D005534:Foot Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013639:Tarsal Bones / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013710:Tendons / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome