Excision versus fusion in painful accessory navicular type 2 in adults: comparison of functional outcome

Background An accessory navicular arises from an unfused secondary ossification center at the navicular tuberosity. This study aims to compare the outcomes of excision versus fusion to treat type 2 symptomatic accessory navicular in terms of clinical and radiologic criteria and the incidence of complications. Patients and Method A prospective comparative study included 30 patients who were divided into two groups, group A included 15 feet underwent fusion, and group B included 15 feet underwent excision. The clinical data of the patients were by the American Orthopaedic Foot and Ankle Society (AOFAS) score, and radiological evaluation (plain X-ray anteroposterior, lateral, and oblique views). Results All operations were performed by the same surgical team. The mean follow-up of the A group and B group was 1.3 years (range: 12 -18 months). There were no statistically significant differences between the distribution of patient’s age and gender between the two groups. The mean preoperative AOFAS score in Group A was 62.53 ± 8.26, and 64.00 ± 7.43 in Group B, this was statistically insignificant. Conclusion We compared the functional outcomes of accessory navicular excision versus fusion in adult patients suffering from symptomatic accessory navicular type 2. We adopted the AOFAS score as the main judge for the clinical results, as it combines the degree of pain the patient suffers, the functional state in the form of scoring the ability of the patient to perform routine daily activities, and foot alignment.