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tibialis posterior Dysfunction

Amol Saxena, Rajan Patel
Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity...
September 15, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sandy McCombe Waller, Chieh-Ling Yang, Laurence Magder, Don Yungher, Vicki Gray, Mark W Rogers
Movement preparation of both anticipatory postural adjustments (APAs) and goal directed movement during a standing reaching task in adults with chronic hemiparesis and healthy controls was investigated. Using a simple reaction time paradigm, while standing on two separate force platforms, subjects received a warning light cue to "get ready to reach" followed 2.5s later by an imperative light cue to "reach as quickly as possible" with the paretic arm (matched arm for controls) to touch a target in front of them for a total of 90 trials...
September 6, 2016: Neuroscience Letters
Yang Xu, Xing-Chen Li, Xiang-Yang Xu
BACKGROUND: The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS: Data were analyzed for 16 patients (20 feet) who had flatfoot without tibialis posterior tendon dysfunction and were treated by calcaneal Z osteotomy combined with arthroereisis between October 2011 and February 2015...
July 9, 2016: Foot & Ankle International
Radostina Vlaeva Cherneva, Zheina Vlaeva Cherneva, Ognian Borisov Georgiev, Daniela Stoichkova Petrova, Julia Ivanova Petrova
BACKGROUND: Oxidative stress and inflammation are assumed as the main pathological triggers for vascular damage in hypersomnolent obstructive sleep apnoea (OSA) patients, whereas their exact role in less symptomatic population is currently unknown. AIM: To determine whether oxidative stress (urinary 8-isoprostane concentration) and inflammation (plasma resistin levels) are associated with vascular damage in non-hypersomnolent (Epworth Sleep Score <11) OSA patients...
June 3, 2016: Clinical Physiology and Functional Imaging
Derek T Bernstein, Joshua D Harris, Pedro E Cosculluela, Kevin E Varner
Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture...
September 1, 2016: Orthopedics
Z Y Wang, X B Wu
Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Kazuya Ikoma, Suzuyo Ohashi, Masahiro Maki, Masamitsu Kido, Yusuke Hara, Toshikazu Kubo
The present study aimed to diagnose complete rupture (CR) and longitudinal rupture (LR) of the posterior tibial tendon (PTT) from the magnetic resonance imaging findings in patients with PTT dysfunction and to analyze and compare the radiographs from each group to identify radiographic indicators related to the progression of PTT injury that would allow the radiographic diagnosis of CR. We evaluated 32 feet in 27 patients with PTT dysfunction (mean age 66.5, range 49 to 82, years). Radiographs were used to acquire weightbearing anteroposterior images of the foot, which were used to measure the talonavicular coverage angle...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Crystal L Ramanujam, John J Stapleton, Thomas Zgonis
The Cobb procedure is useful for addressing stage 2 posterior tibial tendon dysfunction and is often accompanied by a medial displacement calcaneal osteotomy and/or lateral column lengthening. The Cobb procedure can also be combined with selected medial column arthrodesis and realignment osteotomies along with equinus correction when indicated.
January 2016: Clinics in Podiatric Medicine and Surgery
Angela Blasimann, Patric Eichelberger, Yvonne Brülhart, Isam El-Masri, Gerhard Flückiger, Lars Frauchiger, Martin Huber, Martin Weber, Fabian G Krause, Heiner Baur
BACKGROUND: Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis posterior muscle and its tendon can lead to a flattening of the longitudinal arch of the foot. Those affected can experience functional impairment and pain. Less severe cases at an early stage are eligible for non-surgical treatment and foot orthoses are considered to be the first line approach...
2015: Journal of Foot and Ankle Research
Kaihan Yao, Timothy Xianyi Yang, Wei Ping Yew
EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Recognize posterior tibialis tendon dysfunction and begin to include it in differential diagnoses. 2. Recall the basic anatomy and pathology of the posterior tibialis tendon. 3. Assess a patient for posterior tibialis tendon dysfunction with the appropriate investigations and stratify the severity of the condition. 4. Develop and formulate a treatment plan for a patient with posterior tibialis tendon dysfunction. The posterior tibialis is a muscle in the deep posterior compartment of the calf that plays several key roles in the ankle and foot...
June 2015: Orthopedics
Kemal Erol, Ali Yavuz Karahan, Ülkü Kerimoğlu, Banu Ordahan, Levent Tekin, Muhammed Şahin, Ercan Kaydok
Posterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more rarely acute traumatic rupture of the tendon. PTT is the primary dynamic stabilizer of medial arch of the foot. Plantar flexion and inversion of the foot occurs with contraction of tibialis posterior tendon, and arch of the foot becomes elaveted while midtarsal joints are locked and midfoot-hindfoot sets as rigid...
January 28, 2015: Clinics and Practice
Jeff Houck, Christopher Neville, Josh Tome, Adolph Flemister
BACKGROUND: The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD). METHODS: Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group...
September 2015: Foot & Ankle International
Christopher E Gross, Jeannie Huh, Joni Gray, Constantine Demetracopoulos, James A Nunley
BACKGROUND: Lateral column lengthening (LCL) is commonly utilized in treating stage II posterior tibialis tendon dysfunction. This study aimed to analyze the outcomes of LCL with porous titanium wedges compared to historic controls of iliac crest autograft and allograft. We hypothesized that the use of a porous titanium wedge would have radiographic improvement and union rates similar to those with the use of autograft and allograft in LCL. METHODS: Between May 2009 and May 2014, 28 feet in 26 patients were treated with LCL using a porous titanium wedge...
August 2015: Foot & Ankle International
Peter Baquie, Lachlan Fooks, James Pope, Geoff Tymms
BACKGROUND: The mid-foot bears the unheralded and proud, but potentially onerous, task of converting lower limb, vertically oriented stresses into propulsive horizontal motion with the further challenges of speed and direction change over varying terrains. A complex interaction of bones, joints and connective tissues has been cleverly engineered to accommodate these demands. However, these entrusted tissues will encounter acute traumatic stresses or cumulative micro-stresses, leading to structural and functional deficits...
March 2015: Australian Family Physician
Arianna L Gianakos, Keir A Ross, Charles P Hannon, Gavin L Duke, Marcelo P Prado, John G Kennedy
BACKGROUND: The purpose of the current study was to report functional outcomes of tendoscopy for treatment of tibialis posterior tendon pathology as well as compare its diagnostic capability with magnetic resonance imaging (MRI). METHODS: Clinical records and MRI of 12 patients who underwent tendoscopy of the tibialis posterior tendon (TPT) were retrospectively reviewed. Mean follow-up was 31 months (range, 26-43 months). Preoperative MRI findings were compared with tendoscopic findings to assess the diagnostic agreement between each modality...
July 2015: Foot & Ankle International
Mary Claire Manske, Kathleen E McKeon, Jeffrey E Johnson, Jeremy J McCormick, Sandra E Klein
BACKGROUND: Tibialis posterior tendon dysfunction is a common disorder leading to pain, deformity, and disability, although its pathogenesis is unclear. A vascular etiology has been proposed, but there is controversy regarding the existence of a hypovascular region that may render the tendon vulnerable. The purpose of this study was to provide a description of the arterial anatomy supplying the tibialis posterior tendon. METHODS: Sixty adult cadaveric lower extremities were obtained from a university-affiliated body donation program...
April 2015: Foot & Ankle International
M G Amila N Silva, Si Heng Sharon Tan, Hwei Chi Chong, Hsien Ching David Su, Inderjeet Rikhraj Singh
BACKGROUND: The prevalence of tibialis posterior tendon dysfunction (PTTD) is estimated to be as high as 3% to 4% in Western populations, and it is one of the most commonly misdiagnosed conditions of the foot and ankle. METHODS: Clinical and radiological outcomes were assessed in grade IIB PTTD treated with a medializing calcaneal osteotomy, lateral column lengthening, flexor digitorum longus transfer, and tendo-Achilles lengthening. The clinical and radiological findings recorded were the SF-36 score on physical function and mental health, midfoot and hindfoot American Orthopaedic Foot and Ankle Society (AOFAS) clinical scores, the midfoot and visual analog pain scores, as well as the radiological measurements of the hindfoot calcaneal pitch, talo-first metatarsal angle, and medial cuneiform height...
February 2015: Foot & Ankle International
Kornelia Kulig, Szu-Ping Lee, Stephen F Reischl, Lisa Noceti-DeWit
BACKGROUND: Foot pain and diminished functional capacity are characteristics of tibialis posterior tendon dysfunction (TPTD). This study tested the hypotheses that women with TPTD would have impaired performance of a unipedal standing balance test (USBT) and that balance performance would be related to the number of single limb heel raises (SLHR). METHODS: Thirty-nine middle-aged women, 19 with early stage TPTD (stage I and II), were instructed to perform 2 tasks; a USBT and repeated SLHR...
January 2015: Foot & Ankle International
Jeremy L Walters, Samuel S Mendicino
Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and progressive loss of strength of the tibialis posterior tendon. It is most commonly associated with posterior tibial tendon dysfunction that can have an arthritic or traumatic cause. With an increasing population of obese patients, the often misdiagnosed and overlooked posterior tibial tendon dysfunction will only continue to present more often in the foot and ankle specialist's office. This article focuses on the anatomy, classification, and pathomechanics of the flexible adult flatfoot...
July 2014: Clinics in Podiatric Medicine and Surgery
Nicolò Martinelli, Carlo Bonifacini, Alberto Bianchi, Laura Moneghini, Gennaro Scotto, Elena Sartorelli
The acute rupture of the tibialis posterior (TP) tendon, compared to an acute rupture of the Achilles tendon, is a quite uncommon disease to be diagnosed in the emergency department setting. In most cases symptoms related to a TP dysfunction, like weakness, pain along the course of the tendon, swelling in the region of the medial malleolus, and the partial or complete loss of the medial arch with a flatfoot deformity precede the complete rupture of the tendon. In this case report, we describe an acute rupture of the TP tendon following a pronation-external rotation injury of the ankle with no association of a medial malleolus fracture and with no history of a prior flatfoot deformity or symptoms...
May 2014: Journal of the American Podiatric Medical Association
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