Rupture of the posterior tibial tendon causing flat foot. Surgical treatment.

Mann, Roger A.; Thompson, Fred

doi:10.2106/00004623-198567040-00009

Cited by 428 publications

(235 citation statements)

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“…We are not able to comment on this phenomenon as sacrifice of the sole PTT for treatment of CPN palsy usually does not result in an acquired flat foot [15] which happens in a normal foot. The reason for this may be that in the normal foot, the primary evertor of the foot, the peroneus brevis muscle [14], is unopposed in contrast to the palsied foot where loss of peroneus brevis function (as a result of nerve palsy) and loss of the PTT (as a result of tendon transfer) result in a new dynamic balance [15].…”

Section: Discussionmentioning

confidence: 99%

New Tendon Transfer for Correction of Drop-foot in Common Peroneal Nerve Palsy

Vigasio

Marcoccio

Patelli

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Common peroneal nerve palsy has been reported to be the most frequent lower extremity palsy characterized by a supinated equinovarus foot deformity and foot drop. Dynamic tendon transposition represents the gold standard for surgical restoration of dorsiflexion of a permanently paralyzed foot. Between 1998 and 2005, we operated on a selected series of 16 patients with traumatic complete common peroneal nerve palsy. In all cases, we performed a double tendon transfer through the interosseous membrane. The posterior tibialis tendon was transferred to the tibialis anterior rerouted through a new insertion on the third cuneiform and the flexor digitorum longus was transferred to the extensor digitorum longus and extensor hallucis longus tendons. All 16 patients were reviewed at a minimum followup of 24 months (mean, 65 months; range, 24-114 months). The results were assessed using the Stanmore system questionnaire and were classified as excellent in eight, good in five, fair in two, and poor in one. Postoperative static and dynamic baropodometric evaluations also were performed. The proposed procedure, which provides an appropriate direction of pull with adequate length and fixation, is a reliable new method to restore balanced foot dorsiflexion correcting the foot and digit drop and producing a normal gait without the use of orthoses.

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Section: Discussionmentioning

confidence: 99%

New Tendon Transfer for Correction of Drop-foot in Common Peroneal Nerve Palsy

Vigasio

Marcoccio

Patelli

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…In patients with healthy plantar ligaments, particularly in the younger age group, there is evidence that the tendon may be divided and the arch may be maintained. However, when there is degeneration of the plantar ligaments in the middle-aged or older subject, this combination is likely to lead to the classical clinical deformity [8,14,22]. Unfortunately, the diagnosis may be delayed and deformity progressively increases.…”

Section: Discussionmentioning

confidence: 99%

Correction and Prevention of Deformity in Type II Tibialis Posterior Dysfunction

Parsons

Naim

Richards

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Cobb described a method of reconstruction in Johnson and Strom Type II tibialis posterior dysfunction (TPD) using a split tibialis anterior musculotendinous graft. We assessed patient function and satisfaction after a modified Cobb reconstruction in a group of patients with a narrow spectrum of dysfunction, examined a modification of the Johnson and Strom classification to emphasize severity of deformity, and assessed the ability of the technique to prevent subsequent fixed deformity. We prospectively followed 32 patients managed by this technique and a translational os calcis osteotomy with early flexible deformity after failed conservative treatment. There were 28 women and four men with unilateral disease. The average followup was 5.1 years. Staging was confirmed clinically and with imaging. The modified surgery involved a bone tunnel in the navicular rather than the medial cuneiform with plaster for 8 weeks followed by orthotics and physiotherapy.

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“…Historically, adult-acquired flatfoot deformity has been attributed to posterior tibial tendon dysfunction [16,19]. Nevertheless, adult-acquired flatfoot deformity in its current form includes a wide range of deformities affecting the hindfoot, mid-foot, and the ankle.…”

Section: Purposementioning

confidence: 99%