Prichasuk S, Sinphurmsukskul O
Department of Orthopaedic Surgery, Faculty of Medicine, Mahidol University, Ramathibodi Hospital, Bangkok, Thailand.
Foot Ankle Int. 1995 Aug;16(8):500-3. doi: 10.1177/107110079501600807.
The role of relocation of tibialis posterior tendon insertion in the treatment of symptomatic accessory navicular and its relation to the pes planus was studied in 28 patients with symptomatic accessory navicular. Two hundred non-affected individuals were used as control. The calcaneal pitch angle measured radiographically, was used as an indicator of pes planus. All patients had had an excision of the accessory navicular and relocation of the tibialis posterior tendon insertion (Kidner procedure). The average follow-up was 3.2 years. The results were good in 27 patients, and fair in 1 patient, and there were no poor results. Most of the patients demonstrated that the pain and the fatigue signs of the foot and the leg have been improved. Only 3 of 25 patients clinically showed an improvement of the medial longitudinal arch. The calcaneal pitch angle in patients with symptomatic accessory navicular was significantly (14.8 degrees) lower than that in normal subjects (21.4 degrees). An association of pes planus and symptomatic accessory navicular was shown. The Kidner procedure gave good results in the relief of pain and fatigue in patients with symptomatic accessory navicular. The procedure did not significantly restore the height of the medial arch.
在28例有症状的副舟骨患者中，研究了胫后肌腱止点移位在有症状副舟骨治疗中的作用及其与扁平足的关系。选取200名未受影响的个体作为对照。通过X线测量的跟骨倾斜角用作扁平足的指标。所有患者均接受了副舟骨切除及胫后肌腱止点移位术（基德纳手术）。平均随访3.2年。27例患者结果良好，1例结果尚可，无结果不佳者。大多数患者表明足部和腿部的疼痛及疲劳症状有所改善。25例患者中只有3例临床显示内侧纵弓有所改善。有症状副舟骨患者的跟骨倾斜角（14.8度）显著低于正常受试者（21.4度）。显示了扁平足与有症状副舟骨之间的关联。基德纳手术在缓解有症状副舟骨患者的疼痛和疲劳方面效果良好。该手术并未显著恢复内侧足弓的高度。
