Anatomical Study of Sites and Surface Area of the Attachment Region of Tibial Posterior Tendon Attachment

Abstract

Background: The purpose of this study was not only to examine the attachment site but also to quantify the effect of the tibialis posterior tendon (TPT) on each attachment site by examining the surface area of the attachment region. Methods: We examined 100 feet from 50 Japanese cadavers. The TPT attachment to the navicular bone (NB), medial cuneiform bone (MCB), and lateral cuneiform bone (LCB) were set as the main attachment sites (Type I). The attachment seen in Type I with the addition of one additional site of attachment was defined as Type II. Furthermore, surface area was measured using a three-dimensional scanner. Results: Attachment to the NB, MCB, and LCB was present in all specimens. The TPT attachment to the NB, MCB, and LCB comprised 75.1% of total attachment surface area. The ratio of the NB, MCB, and LCB in each type was about 90% in Types II and III, and 70–80% in Types IV–VII. Conclusion: The quantitative results demonstrated the NB, MCB, and LCB to be the main sites of TPT attachment, although individual differences in attachment sites exist, further developing the findings of previous studies.

Anatomical Study of Type Classification and Surface Area of Attachment Sites for Tibialis Anterior Tendon

“…Type III was reported as either absent [8,11] or present in only very small numbers (2-4%) [12,13]. Furthermore, variations in the attachment of foot and ankle muscles such as the tibialis posterior, peroneus longus, and extensor digitorum longus muscles may vary by ethnicity [18][19][20][21]. The present findings thus suggest the possibility of ethnic differences in TAT attachment types and suggest that the TAT attachment type in Japanese is highly likely to be Type II (with two fiber bundles), with rare cases of Type III (with three fiber bundles).…”

Anatomical study of type classification and surface area of attachment sites for tibialis anterior tendon

“…Type III was reported as either absent [10,15] or present in only very small numbers (2-4%) [16,17]. Furthermore, variations in the attachment of foot and ankle muscles such as the tibialis posterior [20], peroneus longus [22], and flexor hallucis longus [23] may vary by ethnicity. The present findings thus suggest the possibility of ethnic differences in TAT attachment types and suggest that the TAT attachment type in Japanese is highly likely to be Type II (with two fiber bundles), with rare cases of Type III (with three fiber bundles).…”

“…The TAT was classified according to differences in the number of fiber bundles as macroscopic: Type I, with one fiber bundle; Type II, with two fiber bundles; and Type III, with three. The attachment site area was measured with reference to the previous study [20]. The attachment site area was identified by peeling away the TAT attachments and the periosteum, then coloring the attachment site with a red pencil (Fig.…”