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A modified method for reconstruction of posterior tibial tendon after resection of juvenile painful type II accessory navicular

The article tests a new way to fix a common foot problem in kids: a painful condition called an accessory navicular bone.

The new method is called "preservation folding suture" and it's compared to a common surgery called the modified Kidner procedure  

The new method does a good job at relieving pain and improving the foot's alignment in the short term, but it seems to be even better at improving the shape of the foot than the older method

Keywords

Flatfoot
Juvenile Painful Type II Accessory Navicular
Posterior Tibial Tendon Reconstruction
Modified Kidner Procedure

Analysis

This study investigates the efficacy of a novel surgical technique, the insertion-preserving folding suture procedure, for the treatment of painful type II accessory navicular in adolescent patients. The authors compare the short-term outcomes of this technique with the modified Kidner procedure, a commonly used method for this condition

The study included 23 adolescent patients with painful type II accessory navicular.  The patients were randomly assigned to either the insertion-preserving folding suture group or the modified Kidner surgery group. The researchers measured the American Orthopedic Foot and Ankle Society Ankle-Hind foot (AOFAS-AH) scores, Meary angle, and Pitch angle of the lateral weight-bearing plain radiographs before and after surgery

The results showed that both methods resulted in significant improvement in AOFAS-AH scores, indicating a reduction in foot pain and improvement in function. However, the insertion-preserving folding suture group demonstrated a significantly greater improvement in Meary angle and Pitch angle, suggesting a better correction of foot alignment

The authors conclude that the insertion-preserving folding suture procedure offers similar short-term clinical outcomes to the modified Kidner procedure but demonstrates greater improvement in the Meary angle and Pitch angle. This suggests that the new technique might be superior in restoring proper foot alignment

The study provides valuable evidence supporting the potential benefits of the insertion-preserving folding suture procedure for treating painful type II accessory navicular. However, it is crucial to acknowledge that this study has limitations, including a relatively small sample size and a short follow-up period. Further research with larger sample sizes and longer follow-up periods is necessary to confirm these findings and to assess the long-term effectiveness of this new technique

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