[Clinical analysis of fusion therapy for typeⅡpainful scaphoid of foot accessory].

Objective: To explore clinical effect of accessory scaphoid bone fusion in treating typeⅡpainful accessory scaphoid bone.

Methods: A retrospective analysis was performed on 26 patients with typeⅡpainful accessory navicular bone treated by accessory navicular bone fusion from January 2012 to June 2022, including 1 male and 25 females, aged from 18 to 70 years old with an average of (44.61±16.32) years old;10 patients with typeⅡA and 16 patients with typeⅡB;20 patients with simple fusion and 6 patients with fusion plus calcaneal translocation osteotomy. Changes of Meary angle, Pitch angle, anteroposterior talar-first metatarsal angle (T1MA), talonavicular coverage angle (TCA), lateral talocalcaneal angle (LTCA) before operation and 6 months after operation were observed and compared, and American Orthopedic Foot and Ankle Society (AOFAS) foot and ankle score and visual analogue scale (VAS) were used to explore clinical effect.

Results: All 26 patients were followed up for 7 to 24 months with an average of (10.72±3.94) months. Meary angle, Pitch angle, T1MA, TCA and LTCA were improved from (9.20±2.57) °, (16.45±3.57) °, (33.34±5.02) °, (22.42±5.86) °, (48.89±4.43) ° before opertaion to (3.33±1.06) °, (22.33±4.56) °, (23.89±3.48) °, (11.83±2.67) °, (36.50±3.50) ° at 6 months after operation, the difference were statistically significant (P<0.01). Postoperative AOFAS foot and ankle score were (86.24±4.33) and (93.18±6.02) for typeⅡA and typeⅡB at 6 months, which were significantly improved compared with those for typeⅡA and typeⅡB before operation (67.34±6.55) and(65.12±9.51), and the difference was statistically significant (P<0.01);20 patients got excellent result, 5 good and 1 poor. Preoperative VAS of typeⅡA(5.67±1.58) and typeⅡB (5.77±1.49) were improved to(2.13±1.01) and (1.43±0.68) at 6 months after operation, with statistical significance(P<0.01).

Conclusion: Fusion of accessory navicular bone in patients with typeⅡpainful accessory navicular bone combined with internal calcaneal osteotomy in patients with partial calcaneal valvaration could effectively correct flat foot deformity and relieve pain, and could be used as a clinical treatment for painful accessory navicular bone.