Kidner Procedure Without Implant Fixation in Accessory Navicular Patient, has a Good Outcome After 1-Year Evaluation at Prof. IGNG Ngoerah Hospital: A Case Report

Introduction: The accessory navicular bone (ANB) is a common developmental anomaly that may cause foot pain, morbidity, and even flatfoot deformity in symptomatic individuals. The Kidner procedure is a widely accepted surgical treatment for symptomatic ANB, typically involving removal of the ANB and reattachment of the posterior tibial tendon. This case report presents a successful 1-year follow-up outcome of an implantless Kidner procedure in a patient with type II ANB. Case Presentation: A 44-year-old female patient presented with a 3-month history of medial-sided left foot pain, aggravated by walking long distances. Physical examination revealed a bony prominence on the inner side of the left foot, with tenderness on palpation. Radiographs demonstrated a type II ANB. The patient underwent an implantless Kidner procedure under general anesthesia, which involved excision of the accessory navicular, osteotomy of the true navicular, and advancement of the tibialis posterior tendon using ethibond sutures. Postoperative follow-ups at 3, 6, and 12 months showed gradual improvement in the American Orthopedic Foot and Ankle Society (AOFAS) score from 75 to 85 and 90, respectively, with no complications or recurrence of symptoms. Discussion: The presence of ANB, particularly type II, can result in foot pain and associated complications, requiring surgical intervention if conservative measures fail. The implantless Kidner procedure presented in this case report demonstrates favorable outcomes in symptom resolution and functional improvement. The use of sutures instead of hardware materials for tendon fixation in this modified procedure appears to be safe and effective. Conclusion: The implantless Kidner procedure is a viable surgical option for the management of symptomatic type II ANB, providing satisfactory results and functional improvement at 1-year follow-up. Further research with larger sample sizes and longer follow-up periods is needed to validate the long-term efficacy of this modified technique.