Sullivan J A, Miller W A
Clin Orthop Relat Res. 1979 Oct(144):233-7.
The Kidner procedure has been the most frequently recommended form of surgical treatment for the painful accessory navicular. This formal relocation of the posterior tibial tendon is said to restore the dynamic balance to the foot which is lost when the posterior tibial tendon gives an abnormal insertion into the accessory ossicle. The literature was reviewed to ascertain what is known or what is believed about the accessory navicular and the role of the posterior tibial tendon in the support of the longitudinal arch of the foot. Eighteen patients who had simple excision of the accessory navicular were reviewed to assess the success of such a procedure. In follow-up they all had very satisfactory results. A second group of 208 patients with non-traumatic foot complaints were reviewed to determine the incidence of accessory navicular and its association with the flat foot. Twenty-nine cases of previously undetected accessory navicular were identified in this group giving us a total of 179 patients without accessory navicular and 49 patients with accessory navicular available for study. There was no significant difference between the arch in these 2 groups of patients. Based on the findings in this study, the accessory navicular plays no role in the development of a flat foot. Simple excision of the prominent ossicle seems to be the surgical procedure of choice when conservative means of management fail.
基德纳手术一直是治疗疼痛性副舟骨最常推荐的手术方式。这种胫后肌腱的正规重新定位据说能恢复足部的动态平衡，而当胫后肌腱异常附着于副骨时，这种平衡就会丧失。回顾相关文献，以确定关于副舟骨以及胫后肌腱在维持足纵弓方面的作用已知或所认为的情况。对18例行单纯副舟骨切除术的患者进行了回顾，以评估该手术的成功率。随访时，他们的结果都非常令人满意。对第二组208例有非创伤性足部问题的患者进行了回顾，以确定副舟骨的发生率及其与扁平足的关联。在该组中发现了29例先前未被检测到的副舟骨，这样我们共有179例无副舟骨患者和49例有副舟骨患者可供研究。这两组患者的足弓之间没有显著差异。基于本研究的结果，副舟骨在扁平足的形成中不起作用。当保守治疗方法失败时，单纯切除突出的副骨似乎是首选的手术方式。
