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posterior tibial tendon dysfunction

F G Usuelli, C A Di Silvestri, R D'Ambrosi, C Maccario, E W Tan
PURPOSE: Medial displacement calcaneal osteotomy with flexor digitorum longus transfer is a common treatment for the management of the adult flatfoot associated with posterior tibial tendon dysfunction. In the literature, there is a paucity of information regarding the ability of patients to return to sport and recreational activities after this surgical procedure. The purpose of this retrospective clinical study was to assess the rate and type of athletic activities that patients participated in before and after medial displacement calcaneal osteotomy with flexor digitorum longus transfer...
October 15, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthias Braito, Martina Wöß, Benjamin Henninger, Michael Schocke, Michael Liebensteiner, Dennis Huber, Martin Krismer, Rainer Biedermann
BACKGROUND: The purpose of this study was to investigate the radiological and surgical correlation between preoperative magnetic resonance images (MRI) and the intraoperative findings in patients with acquired adult flatfoot. RESULTS: The overall radiological-surgical correlation between preoperative MRI and the intraoperative findings for posterior tibial tendon insufficiency was only slight to fair in our patient's series. Comparing the most commonly used posterior tibial tendon classification systems, the classification of Rosenberg et al...
2016: SpringerPlus
Akinobu Nishimura, Shigeto Nakazora, Aki Fukuda, Ko Kato, Akihiro Sudo
A 25-year-old man with a pronation-external rotation type of fracture was surgically treated using a fibular plate. Five years later, he underwent resection of bone hyperplasia because of the ankle pain and limitation of range of motion. Thereafter, the left ankle became intermittently painful, which persisted for about one year. He presented at the age of 43 with persistent ankle pain. Physical and image analysis findings indicated a diagnosis of posttraumatic posterior tibial tendinitis, which we surgically treated using tendoscopy...
2016: Case Reports in Orthopedics
Tun Hing Lui
A tear of the spring ligament is frequently associated with posterior tibial tendon dysfunction. Repair of the damaged spring ligament is an important component of surgical reconstruction in the treatment of posterior tibial tendon dysfunction because it is a major anatomic contributor to the integrity of the medial longitudinal arch, particularly if the dynamic support of the posterior tibial tendon is compromised. Extensive dissection is required for exposure and repair of the ligament because it is a deep-seated structure...
December 2015: Arthroscopy Techniques
Jonathan Zember, Zehava Rosenberg, Ignacio Rossi, Chimere Mba-Jones, Jenny Bencardino
OBJECTIVE: Fluid along the frondiform ligament, the sinus tarsi stem of the inferior extensor retinaculum (IER), can approximate the extensor digitorum longus (EDL), at times simulating tenosynovitis. Our purpose, based on MRI and cadaveric studies, was to further evaluate this scantly described phenomenon, to identify associated findings and to alert the radiologists to the potential pitfall of over diagnosing EDL tenosynovitis. MATERIALS AND METHODS: Two musculoskeletal radiologists retrospectively reviewed the radiology reports and MRI studies of 258 ankle MRI exams, performed at our institution, for fluid along the frondiform ligament extending toward the EDL...
August 2016: Skeletal Radiology
Bernard Mengiardi, Clinton Pinto, Marco Zanetti
The spring ligament complex is an important stabilizer of the medial ankle, together with the posterior tibial tendon (PTT) and the deltoid ligament complex. Lesions in these stabilizers result in acquired adult flatfoot deformity. The spring ligament complex includes three ligaments: the superomedial calcaneonavicular ligament, the medioplantar oblique calcaneonavicular ligament, and the inferoplantar longitudinal calcaneonavicular ligament. Normal MR imaging anatomy of the spring ligament complex and the PTT are described and illustrated in detail...
February 2016: Seminars in Musculoskeletal Radiology
Joseph T O'Neil, David I Pedowitz, Yehuda E Kerbel, Jason L Codding, Adam C Zoga, Steven M Raikin
BACKGROUND: Abnormalities of the peroneal tendons can frequently be identified on routine MRI of the foot and ankle. Previous studies in the orthopedic literature have discussed the prevalence of abnormal MRI findings in asymptomatic patients, most notably with regards to the spine and shoulder. The purpose of this study was to determine the prevalence of abnormal findings of the peroneal tendons on MRI in asymptomatic individuals. METHODS: We retrospectively reviewed all foot and ankle MRIs from 2 independent time periods that were either performed or reviewed at our institution...
July 2016: Foot & Ankle International
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
Amol Saxena, Alessio Giai Via, Nicola Maffulli, Haywan Chiu
Subtalar joint arthroereisis (STA) can be used in the management of adult acquired flatfoot deformity (AAFD), including posterior tibial tendon dysfunction. The procedure is quick and normally causes little morbidity; however, the implant used for STA often needs to be removed because of sinus tarsi pain. The present study evaluated the rate and risk factors for removal of the implant used for STA in adults treated for AAFD/posterior tibial tendon dysfunction, including patient age, implant size, and the use of endoscopic gastrocnemius recession...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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
Brian C Werner, Grant E Norte, Michael M Hadeed, Joseph S Park, Mark D Miller, Joseph M Hart
OBJECTIVE: To objectively compare outcomes of nonoperative management and posterior tibial tendon (PTT) transfer for peroneal nerve injury due to multiligament knee injury (MLI). DESIGN: Retrospective cohort study with prospective follow-up. SETTING: Tertiary care institution. PATIENTS: Ten patients with peroneal nerve injury due to MLI (5 managed nonoperatively, 5 with PTT transfer) were evaluated and a control group of 4 patients without peroneal nerve injury...
January 19, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Naoki Yoshioka, Kazuya Ikoma, Masamitsu Kido, Kan Imai, Masahiro Maki, Yuji Arai, Hiroyoshi Fujiwara, Daisaku Tokunaga, Nozomu Inoue, Toshikazu Kubo
BACKGROUND: The recent classifications for posterior tibial tendon dysfunction (PTTD) stage II are based on forefoot deformity, but there is still no consensus regarding a detailed explanation of the clinical condition. The purposes of this study were to clarify the clinical condition of flatfoot deformity using three-dimensional (3D) computed tomography (CT) imaging under loading on both healthy and flat feet and to compare 3D movement of the forefoot in response to load. METHODS: Ten volunteers and 10 PTTD stage II patients with symptomatic flatfoot deformity were examined...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Christopher Neville, Mary Bucklin, Nathaniel Ordway, Frederick Lemley
STUDY DESIGN: Controlled laboratory, repeated measures. BACKGROUND: Posterior tibial tendon dysfunction is a common musculoskeletal problem that includes tendon degeneration and collapse of the medial arch of the foot (flatfoot deformity). Ankle-foot orthoses (AFOs) typically are used to correct flatfoot deformity. Correction of flatfoot deformity involves increasing forefoot adduction, forefoot plantar flexion, and hindfoot inversion. OBJECTIVES: To test whether a foot orthosis with a lateral extension reduces forefoot abduction in patients with stage II posterior tibial tendon dysfunction while walking...
January 2016: Journal of Orthopaedic and Sports Physical Therapy
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
James T Maskill, Gregory C Pomeroy
The modified Kidner procedure and flexor digitorum longus tendon transfer are common procedures used today when addressing posterior tibial tendon dysfunction. These techniques are often used in conjunction with a combination of osteotomies to correct flatfoot deformity, and have been proved to be reliable and predictable.
January 2016: Clinics in Podiatric Medicine and Surgery
M C Cöster, B E Rosengren, A Bremander, M K Karlsson
BACKGROUND: Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome. METHODS: We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D)...
December 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Norman Espinosa, Marc A Maurer
Posterior tibial tendon dysfunction can be a difficult entity to treat in the athletic population. Understanding the deformity components allows the physician to maximize nonoperative intervention with orthotics and physical therapy. Not all patients improve with nonoperative treatment, and surgical intervention can be successful in minimizing symptoms. Although return to full athletic activity is not universally possible, an active lifestyle is possible for many after surgical reconstruction.
October 2015: Clinics in Sports Medicine
Jesús Vilá y Rico, Verónica Jiménez Díaz, Beatriz Bravo Giménez, María Ángeles Mellado Romero, Cristina Ojeda Thies
BACKGROUND: The goal of this study was to compare results with arthroscopic posterior subtalar arthrodesis between patients treated for adult-acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction and patients with posttraumatic subtalar arthritis. METHODS: Retrospective case series of 61 consecutive patients (group 1: posttraumatic arthritis, n = 37; group 2: AAFD, n = 24) averaging 49 years of age (range, 21-72 years) undergoing posterior arthroscopic subtalar arthrodesis via 1 or 2 percutaneous 6...
February 2016: Foot & Ankle International
Lise Van Gestel, Saskia Van Bouwel, Johan Somville
In this review article, the authors give an overview of the currently available soft tissue and bony procedures in the treatment of the adult acquired flexible flatfoot. Instead of starting from the classification for posterior tibial tendon dysfunction, described by Johnson and Storm, the authors address the flatfoot from a more anatomical point of view. Based on this, they will try to define a treatment algorithm.
June 2015: Acta Orthopaedica Belgica
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
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