Painful Accessory Navicular: Augmented Kidner Procedure With Flexor Digitorum Longus Transfer

Presence of a painful accessory navicular with or without flatfoot.

Often associated with equinus contracture as well. Posterior tibial tendon function is usually intact but may be weakened secondary to pain.

The enlarged area of the medial hindfoot may also cause problems with regular footwear and footwear for sports activities, such as ski boots.

Initial treatment can consist of immobilization of the foot and ankle to see if bony union can be achieved.

There is a bony prominence along the medial hindfoot. This can cause problems with shoe fitting and sports, especially when a tight boot is worn, such as in skiing/snowboarding or roller skating. Pain can be present if a twisting injury causes motion at a previously securely-bound bony interface.

Plain radiographs are obtained.

• Standing anteroposterior (AP; Fig. 28.1A ) and lateral ( Fig. 28.1B ) views will show the deformity.

  

• The accessory navicular may be attached to the medial navicular by bone or fibrous tissue, or may be unattached within the posterior tibialis tendon.