Biomedical Technology · Published 2026-02-26 · DOI 10.1016/j.bmt.2026.100136
Background: The surgical management of adolescent flexible flatfoot with accessory navicular injury remains controversial. Technology: We developed a minimally invasive technique combining biocompatible screw–based hindfoot biomechanical alignment correction with Kidner surgery. A biocompatible screw was implanted in the tarsal sinus to stabilize the subtalar joint and maintain normal anatomical relationships of the talocalcaneal and talonavicular joints, thereby correcting hindfoot alignment. Results: Postoperatively, the hindfoot valgus angle improved significantly from 11.3° ± 3.3° to 3.0° ± 1.6° (P < 0.001), and the Meary angle decreased from 19.8° ± 9.4° to 4.6° ± 4.1° (P < 0.001), indicating effective reconstruction of hindfoot and midfoot alignment. Functional outcomes also improved markedly: AOFAS scores rose from 71.6 ± 12.8 preoperatively to 93.7 ± 8.1 postoperatively (P < 0.001), and VAS pain scores dropped from 6.1 ± 3.1 to 2.6 ± 1.1 (P < 0.001). No serious complications were observed during follow-up, and the biocompatible screws demonstrated excellent stability and biocompatibility. Conclusion: Our findings suggest that this combined approach effectively corrects pathological biomechanics, achieves anatomical realignment, and significantly enhances functional recovery while alleviating pain. It represents a safe, feasible, and promising strategy for treating adolescent flexible flatfoot with accessory navicular injury, offering a novel pathway toward precise, minimally invasive care.
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