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Posterior tibial tendon disorder

David Pedowitz, David Beck
Disorders of the anterior tibial tendon (ATT) are rare, and relatively few series have been described in the literature. Ruptures of the ATT are more common than tendinopathies of the ATT. For those patients with a tendinopathy, initial treatment may include activity and shoe-wear modifications.
December 2017: Foot and Ankle Clinics
Samuel Ka-Kin Ling, Tun Hing Lui
BACKGROUND: Adult acquired flatfoot deformity is a commonly seen condition with a large clinical spectrum. It ranges from asymptomatic subjects to severely disabled arthritic patients. Posterior tibialis tendon dysfunction is a common cause of adult acquired flatfoot deformity. METHODS: This article systematically reviews the published literature from books and journals that were either originally written or later translated into the English language regarding the subject of posterior tibialis tendon dysfunction...
2017: Open Orthopaedics Journal
Manuel Monteagudo, Ernesto Maceira, Pilar Martinez de Albornoz
Tendoscopy is an apparently safe and reliable procedure to manage some foot and ankle disorders.The most common foot and ankle tendoscopies are: Achilles; peroneal; and posterior tibial tendon.Tendoscopy may be used as an adjacent procedure to other techniques.Caution is recommended to avoid neurovascular injuries.Predominantly level IV and V studies are found in the literature, with no level I studies still available.There are many promising and evolving endoscopic techniques for tendinopathies around the foot and ankle, but studies of higher levels of evidence are needed to strongly recommend these procedures...
December 2016: EFORT open reviews
M Guelfi, A Pantalone, R M Mirapeix, D Vanni, F G Usuelli, M Guelfi, V Salini
OBJECTIVE: Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and a progressive loss of strength of the posterior tibial tendon (PTT). This condition is commonly associated with PTT dysfunction or rupture, which can have an arthritic or a traumatic etiology. Several causes have been proposed to explain the clinical evidence of tendon degeneration observed at the time of surgery including trauma, anatomical, mechanical, inflammatory and ischemic factors...
January 2017: European Review for Medical and Pharmacological Sciences
Beverley Durrant, Nachiappan Chockalingam, Christopher Morriss-Roberts
BACKGROUND: Posterior tibial tendon dysfunction is a disabling pathologic flatfoot disorder. Evidence supports the notion that this condition is poorly diagnosed by health-care professionals. In addition, opinion is divided as to the most appropriate assessment and diagnostic techniques used to reflect the progression or stage of the condition. Hence, this study intended to explore the views and opinions of health-care professionals who may be involved in its assessment and diagnosis...
January 2016: Journal of the American Podiatric Medical Association
R A Fuhrmann, T Pillukat
OBJECTIVE: Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. INDICATIONS: Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. CONTRAINDICATIONS: Inflammation, vascular disturbances, nicotine abuse. SURGICAL TECHNIQUE: Approach dependent on assessment. Lateral approach: Supine position...
June 2016: Operative Orthopädie und Traumatologie
Chi-Chuan Wu, Ching-Lung Tai
UNLABELLED: An absolutely convincing technique of anterior transfer of the tibialis posterior (TP) tendon for treating drop foot has not been developed. Thirty-seven consecutive adult patients with drop foot owing to deep peroneal nerve injury were treated with bone-to-bone TP tendon transfer. The TP tendon with a small bony attachment was procured from the undersurface of the navicula and then transferred through a tunnel of the interosseous membrane. The navicular attachment was implanted in the tunnel of the navicula or intermediate cuneiform...
March 2015: Acta Orthopaedica Belgica
Beverley Durrant, Nachiappan Chockalingam, Christopher Morriss-Roberts
BACKGROUND: Posterior tibial tendon dysfunction is a disabling pathologic flatfoot disorder. Evidence supports the notion that this condition is poorly diagnosed by health-care professionals. In addition, opinion is divided as to the most appropriate assessment and diagnostic techniques used to reflect the progression or stage of the condition. Hence, this study intended to explore the views and opinions of health-care professionals who may be involved in its assessment and diagnosis...
July 22, 2015: Journal of the American Podiatric Medical Association
Mehmet Armangil, H Çağdaş Basat, S Sinan Bilgin
Iatrogenic peripheral nerve injuries can result from numerous medical procedures, particularly transection, stretching, compression, injections, heat, radiation, and the use of anticoagulant agents. Late diagnosis may lead to atrophy of the motor endplate and result in poor outcomes. We report a case in which the posterior tibial nerve was accidentally sectioned as the posterior tibial tendon for transfer to the anterior tibial tendon in the reconstruction of drop foot. This iatrogenic complication ultimately required foot amputation...
2015: Acta Orthopaedica et Traumatologica Turcica
Benjamin E Stein, Lew C Schon
The management of posterior tibial tendon dysfunction in adults has evolved substantially, and controversy persists regarding a specific recommended algorithm for treatment. The current focus is on early diagnosis and treatment of this disorder with joint-sparing surgeries, such as corrective osteotomies and tendon transfers, when nonsurgical modalities have been exhausted. It is helpful to be familiar with the pertinent pathophysiology and diagnostic pearls associated with posterior tibial tendon dysfunction, its treatment options, pertinent literature, and technique tips for the procedures currently being used...
2015: Instructional Course Lectures
Manuel Monteagudo, Ernesto Maceira
The posterior tibial tendon (PTT) helps the triceps surae to work more efficiently during ambulation. Disorders of the PTT include tenosynovitis, acute rupture, degenerative tears, dislocation, instability, enthesopathies, and chronic tendinopathy with dysfunction and flat foot deformity. Open surgery of the PTT has been the conventional approach to deal with these disorders. However, tendoscopy has become a useful technique to diagnose and treat PTT disorders. This article focuses on PTT tendoscopy and tries to provide an understanding of the pathomechanics of the tendon, indications for surgery, surgical technique, advantages, complications, and limitations of this procedure...
March 2015: Foot and Ankle Clinics
Kyle S Peterson, Christopher F Hyer
Adult acquired flatfoot deformity is a debilitating musculoskeletal condition affecting the lower extremity. Posterior tibial tendon dysfunction (PTTD) is the primary etiology for the development of a flatfoot deformity in an adult. PTTD is classified into 4 stages (with stage IV subdivided into stage IV-A and IV-B). This classification is described in detail in this article.
July 2014: Clinics in Podiatric Medicine and Surgery
Jared M Maker, James M Cottom
Adult acquired flatfoot deformity is a progressive disorder with multiple symptoms and degrees of deformity. Stage II adult acquired flatfoot can be divided into stage IIA and IIB based on severity of deformity. Surgical procedures should be chosen based on severity as well as location of the flatfoot deformity. Care must be taken not to overcorrect the flatfoot deformity so as to decrease the possibility of lateral column overload as well as stiffness.
July 2014: Clinics in Podiatric Medicine and Surgery
Marius Molund, Lars Engebretsen, Kjetil Hvaal, Jan Hellesnes, Elisabeth Ellingsen Husebye
BACKGROUND: Knee dislocation may be associated with an injury to the common peroneal nerve with a subsequent foot drop. Previous studies have demonstrated good functional results after posterior tibial tendon transfer in patients with foot drop. No studies, to our knowledge, have focused exclusively on knee dislocation as the cause of common peroneal nerve injury leading to foot drop. QUESTIONS/PURPOSES: We determined the percentage of patients developing common peroneal nerve paresis after knee dislocation, the symptom improvement rate in these patients, and patient-reported outcomes (American Orthopaedic Foot and Ankle Society [AOFAS] ankle-hindfoot score), ankle dorsiflexion strength, and ROM in patients with no symptom improvement treated with posterior tibial tendon transfer...
September 2014: Clinical Orthopaedics and related Research
Vinod Kumar Panchbhavi
Tendon transfer procedures are useful for replacing a dysfunctional or diseased tendon or for restoring muscle imbalance. The tendon to be transferred is harvested as distal as is necessary to provide adequate length for rerouting and attachment at the different site. The harvesting of tendon itself can be attained using an open surgical approach or minimally invasive percutaneous techniques that limit surgical exposure. This article describes percutaneous techniques for tendon transfer procedures used to address foot and ankle disorders...
March 2014: Foot and Ankle Clinics
Jose Antônio Veiga Sanhudo, Joao Luiz Ellera Gomes
BACKGROUND: Leg length discrepancy (LLD) is associated with a variety of orthopaedic disorders and biomechanical gait changes that involve possible overload of the posterior tibial tendon (PTT). In view of the biomechanical disturbances induced by LLD, an association may exist between LLD and PTT dysfunction (PTTD). PURPOSE: To compare the frequency and magnitude of LLD between subjects with and without PTTD and ascertain whether associations exist between clinical features and presence of dysfunction...
April 2014: Foot & Ankle Specialist
Premal Das, Julius Kumar, G Karthikeyan, P S S Sundar Rao
OBJECTIVES: Tibialis posterior tendon transfer (TPT) technique, using either the Circum-tibial (CT) or Inter-osseus (IO) route is the standard surgical technique to correct foot drop. The selection of the route of transfer is usually dependent on the surgeon's preference. This study aims to identify criteria to help make that selection. SUBJECTS AND METHODS: A study was carried out on 381 feet during the period 1999 to 2010. All the patients operated during this period were included in the study...
September 2013: Leprosy Review
Andrew R Hsu, Christopher E Gross, Simon Lee, Dominic S Carreira
Advances in foot and ankle arthroscopy have allowed surgeons to diagnose and treat a broadening array of disorders that were previously limited to open procedures. Arthroscopy of the posterior ankle, subtalar joint, and first metatarsophalangeal joint and tendoscopy can be used to address common foot and ankle ailments, with the potential benefits of decreased pain, fast recovery, and low complication rates. Posterior ankle and subtalar arthroscopy can be used to manage impingement, arthrofibrosis, synovitis, arthritis, fractures, and osteochondral defects...
January 2014: Journal of the American Academy of Orthopaedic Surgeons
Ali Aydin, Murat Topal, Kutsi Tuncer, Umut Canbek, Vahit Yildiz, Mehmet Kose
BACKGROUND: To study the efficacy of extramembranous transfer of the tibialis posterior (posterior tibial) tendon for the treatment of drop foot deformity in children. MATHERIALS AND METHODS: This study included 24 patients (11 girls and 13 boys) with drop foot deformity, who underwent tibialis posterior tendon transfer. The mean age was 12.33 years (range: seven to18 years), and the mean follow-up period was 32.54 months (range: 24 - 55 months). Drop foot developed due to different levels of nerve injury associated with trauma or surgical operation in 18 (75 %) patients, and due to meningomyelocele in six (25 %) patients...
November 2013: Archives of Iranian Medicine
Milomir Ninković, Marina Ninković
BACKGROUND: An original surgical technique for the correction of drop foot is demonstrated. METHODS: Eighteen patients with drop foot underwent transfer of the lateral, medial, or both heads of the gastrocnemius muscle to the tendons of the anterior and/or lateral muscle group of the lower leg. The transferred muscle was reinnervated by nerve coaptation between the undamaged proximal part of the deep peroneal nerve and the motor branch of the tibial nerve supplying the gastrocnemius muscle...
September 2013: Plastic and Reconstructive Surgery
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