Analysis of Causes and Prevention Strategies of Complications for Adult Patients with Painful Accessory Navicular Pain Syndrome Treated with Posterior Tibial Tendon Reconstruction Using TwinFix Anchor

WANG Yuqing; JIN Ruina; KANG Qiangjun

doi:10.3969/j.issn.1002-3429.2025.06.011

Abstract：Objective To investigate the causes and prevention strategies of complications in the treatment of adult patients with painful accessory navicular syndrome treated with posterior tibial tendon reconstruction using TwinFix anchor.Methods The clinical data of 32 adult patients with painful accessory navicular syndrome who underwent posterior tibial ten-don reconstruction using TwinFix anchor from January 2013 to January 2023 were retrospectively analyzed.Results Postoper-ative pain occurred in 12 of the 32 patients(37.5%),including pain in the incision,around the incision and other areas of the medial foot in 10 patients,and the anchor strapping into the joint and the exposed nail tail irritating the skin in 1 patient respectively.After symptomatic treatment such as anti-infection,detumescence,pain relief or surgical revision treatment,the symptoms were relieved.Peripheral nerve injury-related plantar-numbness occurred in 5 patients(15.6%),and the symp-toms were improved after symptomatic treatment including detumescence and nutritional nerve.Postoperative incision infection and skin necrosis were found in 3 patients(9.4%).The infection was controlled and the incision healed after anti-infection treatment and incision expansion surgery.There were9 patients(28.1%)with limited foot function,and symptoms were re-lieved after rehabilitation exercise.There were3 patients(9.4%)of anchor loss.After the second operation and rehabilita-tion exercise,the patients'condition improved.At 12 months after operation,AOFAS ankle-posterior foot function score[(86.03±4.83)points]was significantly improved compared with that before operation[(49.34±8.41)points](P＜0.01).Conclusion Posterior tibial tendon reconstruction using TwinFix anchor in the treatment of adult patients with painful accessory navicular syndrome can cause symptom-related complications and complications related to poor postoperative function improvement,which are related to long duration of operation,rough operation and anchor loss.Careful operation should be performed during the the procedure to shorten the duration of operation as much as possible,and postoperative complications should be actively managed to avoid serious consequences.