Kidner procedure on symptomatic accessory navicular: a case report


  • I. Gusti Ngurah Wien Aryana Department of Orthopaedic and Traumatology, Sanglah Hospital/Faculty of Medicine, University of Udayana, Bali, Indonesia
  • I. Made Arditya Dwi Yudistira Department of Orthopaedic and Traumatology, Sanglah Hospital/Faculty of Medicine, University of Udayana, Bali, Indonesia



Accessory naviculare, Kidner procedure, Symptomatic case


Accessory navicular bone (ANB) is present in 4-20% of the general population. It can cause of midfoot pain and consequently may lead to flat foot. The patient usually presents with pain and swelling on the medial aspect of the foot with difficulty on walking. Diagnosis is often delayed. We report a case of symptomatic accessory navicular on a 30 years old female patient who complained of pain in the medial area of left foot for 2 years, and the pain getting worse in the last 2 weeks. Accessory navicular bone treatment may be non-surgical or surgical treatment in order to improve the symptoms. The following may be used: immobilisation by plaster splint, use of boots when walking, which allow the affected area to rest and reduce inflammation, use of an ice bag covered with a thin towel applied on the affected area in order to reduce swelling, oral non-steroidal anti-inflammatory drugs (NSAID). Surgical treatment of this condition involves removing the accessory bone (this additional bone is not necessary for normal foot function), remodeling the area, and repairing the posterior tibial tendon to improve its function. The most commonly used procedure to treat the symptomatic accessory navicular is Kidner procedure. The accessory navicular is a commonly occurring deformity that, because of its significant accompanying pathomechanical considerations, is closely associated with the pathologic flexible flatfoot. By recognizing and treating this progressive, debilitating deformity, both conservatively and surgically, the astute practitioner will be able to resolve discomfort, improve dysfunction, and restore quality of life.


Romanowski CA, Barrington NA. The accessory navicular-an mportant cause of medial foot pain. Clin Radiol. 1992;46:261-4.

Pedowitz WJ, Kovatis P. Flatfoot in the adult. J Am Acad Orthop Surg. 1995;3(5):293-302.

Fredrick LA, Beall DP, Ly JQ, Fish JR. The symptomatic accessory navicular bone: a report and discussion of the clinical presentation. Curr Prob Diagn Radiol. 2005;34(2):47-50.

Abourazzak FE, Shimi M, Azzouzi H, Mansouri S, El Mrini A, Harzy T. An unusual cause of medial foot pain: the cornuate navicular. Eur J Rheumatol. 2015;2(1):33-4.

Kean JR. Foot problems in the adolescent. Adolesc Med State Art Rev. 2007;18(1):182-91,xi.

Miller TT. Painful accessory bones of the foot. Semin Musculoskelet Radiol. 2002;6:153-61.

Schweitzer ME, Karasick D. MR Imaging of Disorders of the Posterior Tibialis Tendon. Am J Roentgenol. 2000;175:627-35.

Tuite MJ. MR imaging of the tendons of the foot and ankle. Semin Musculoskelet Radiol. 2002;6:119-31.

Bencardino JT, Rosenberg ZS. MR imaging and CT in the assessment of osseous abnormalities of the ankle and foot. Magn Reson Imaging Clin N Am. 2001;9:567-78.

Bareither DJ, Muehleman CM, Feldman NJ. Os tibiale externum or sesamoid in the tendon of tibialis posterior. J Foot Ankle Surg. 1995;34(5):429-34.

Grogan DP, Gasser SI, Ogden JA. The painful accessory naviculara clinical and histopathological study. Foot Ankle. 1989;10:164-9.

Chiu NT, Jou IM, Lee BF, Yao WJ, Tu DG, Wu PS. Symptomatic and asymptomatic accessory navicular bones: findings of Tc-99m MDP bone scintigraphy. Clin Radiol. 2000;55(5):353-5.




How to Cite

Aryana, I. G. N. W., & Dwi Yudistira, I. M. A. (2020). Kidner procedure on symptomatic accessory navicular: a case report. International Journal of Research in Medical Sciences, 8(9), 3351–3354.



Case Reports