Outcome of Fusion of a Painful Accessory Navicular to the Primary Navicular

Abstract

BACKGROUND: An accessory navicular bone may cause pain due to continuous irritation at its interface with the navicular. The authors performed the fusion of the accessory navicular and navicular with screw(s) to relieve the symptoms while preserving the continuity of the posterior tibial tendon. MATERIALS AND METHODS: We analyzed the clinical and radiological outcomes of 31 consecutive patients (34 feet) with a painful type II accessory navicular. RESULTS: Bone union was confirmed on plain radiography in 28 (82%) of 34 feet. Twenty-two patients (24 feet) were assessed as excellent, two (three feet) as good, and one (one foot) as fair. Nonunion developed in six patients (six feet) and was defined as poor. CONCLUSION: When conservative treatment fails to relieve pain in a type II accessory navicular, fusion of the accessory navicular to the navicular may successfully relieve pain without disrupting the tibialis posterior tendon insertion.