Rupture of the Posterior Tibial Tendon. Evaluation of Injury of the Spring Ligament and Clinical Assessment of Tendon Transfer and Ligament Repair*

Gazdag, André R.; Cracchiolo, Andrea

doi:10.2106/00004623-199705000-00006

Cited by 194 publications

(116 citation statements)

References 8 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…The abnormal kinematics of greater rearfoot eversion, increased MLA angle, and increased forefoot abduction are consistent with current theories regarding posterior tibialis muscle function 11,31,43 and loss of secondary ligamentous support. 2,12 The subjects with stage II PTTD showed significantly greater rearfoot eversion, MLA angle, and forefoot abduction during specific phases of stance, with significant differences ranging between 4°to 10°compared to the control group.…”

Section: Discussionmentioning

confidence: 97%

“…This failure of a gradual shock absorption to occur may contribute to abnormal stresses on secondary ligamentous support (spring ligament, plantar fascia, interosseous talocalcaneal ligament) as the foot is loaded. 2,12 During the terminal stance and preswing phases of gait, abnormal kinematics of the subjects with PTTD suggests a failure to position the foot effectively for push off. Rearfoot inversion and increased height of the MLA may indicate that the talonavicular and calcaneocuboid joints are in a nonparallel position, transforming the foot into a rigid lever through bony contact.…”

Section: Discussionmentioning

confidence: 99%

“…Because synergistic muscles, such as the flexor digitorum longus, are unable to adequately compensate for the decreased contribution of the posterior tibialis muscle, abnormal foot postures develop. 14,30,31 Persisting abnormal foot postures may also contribute to breakdown of secondary ligamentous supports (eg, spring ligament, plantar fascia, and deltoid ligament), 2,12 further magnifying the flatfoot deformity. 23,25,28,43 These deviations point to the importance of early recognition and management of adult acquired flatfoot deformity in preventing disease progression and protecting secondary ligamentous supports.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Tome

Nawoczenski²,

Flemister³

et al. 2006

J Orthop Sports Phys Ther

158

178

View full text Add to dashboard Cite

Study Design: A 2 × 4 mixed-design ANOVA with a fixed factor of group (posterior tibialis tendon dysfunction [PTTD] and asymptomatic controls), and a repeated factor of phase of stance (loading response, midstance, terminal stance, and preswing). Objective: To compare 3-dimensional stance period kinematics (rearfoot eversion/inversion, medial longitudinal arch [MLA] angle, and forefoot abduction) of subjects with stage II PTTD to asymptomatic controls. Background: Abnormal foot postures in subjects with stage II PTTD are clinical indicators of disease progression, yet dynamic investigations of forefoot, midfoot, and rearfoot kinematic deviations in this population are lacking. Methods: Fourteen subjects with stage II PTTD were compared to 10 control subjects with normal arch index values. Subjects were matched for age, gender, and body mass index. A 5-segment, kinematic model of the leg and foot was tracked using an Optotrak Motion Analysis System. The dependent kinematic variables were rearfoot inversion/eversion, forefoot abduction/adduction, and the MLA angle. An ANOVA model was used to compare kinematic variables between groups across 4 phases of stance.Results: Subjects with PTTD demonstrated significantly greater rearfoot eversion (P = .042), MLA angle (P = .008) and forefoot abduction angles (PϽ.005) during specific phases of stance. Subjects with PTTD demonstrated significantly greater rearfoot eversion (PϽ.004) and MLA angles (PϽ.009) by 6.2°and 8.0°, respectively, during loading response when compared to controls. During preswing, the subjects with PTTD demonstrated a significantly greater MLA angle (PϽ.002) and a forefoot abduction angle (PϽ.001) which exceeded that of the controls by 10.0°. Conclusions: The abnormal kinematics observed at the rearfoot, midfoot, and forefoot across all phases of stance implicate a failure of compensatory muscle and secondary ligamentous support to control foot kinematics in subjects with stage II PTTD.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Tome

Nawoczenski²,

Flemister³

et al. 2006

J Orthop Sports Phys Ther

158

178

View full text Add to dashboard Cite

show abstract

“…Accordingly, validation of the Johnson and Strom classification has been difficult. Despite the inherent limitations of using a system that has not been validated, advancement of technology allowing better understanding of the deformity, and availability of more-complex and more-detailed classification systems, the Johnson and Strom classification persists widely, which may indicate the value to this system to users [4,5,8,9,12,13,24,26,27].…”

Section: Validationmentioning

confidence: 99%

“…Valgus secondary to bone loss in lateral ankle compartment and deltoid insufficiency include all anatomic aspects of the pes planus deformity; by focusing on the role of the posterior tibial tendon, this system misses the importance of the spring ligament, deltoid ligament, naviculocuneiform joint, and tarsometatarsal joints, all of which have been shown to be involved, as have the hindfoot and forefoot in the deformity [8,9,12,21,22]. As a result, numerous authors [5,9,20,24,27] have expanded the original classification system in an attempt to include the various structures involved.…”

Section: Limitationsmentioning

confidence: 99%

Classifications in Brief: Johnson and Strom Classification of Adult-acquired Flatfoot Deformity

Abousayed

Tartaglione

Rosenbaum

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

A computational model of force within the ligaments and tendons in progressive collapsing foot deformity

Malakoutikhah

Madenci

Latt

2022

Journal Orthopaedic Research

View full text Add to dashboard Cite

Progressive collapsing foot deformity results from degeneration of the ligaments and posterior tibial tendon (PTT). Our understanding of the relationship between their failures remains incomplete. We sought to improve this understanding through computational modeling of the forces in these soft tissues. The impact of PTT and ligament failures on force changes in the remaining ligaments was investigated by quantifying ligament force changes during simulated ligament and tendon cutting in a validated finite element model of the foot. The ability of the PTT to restore foot alignment was also evaluated by increasing the PTT force in a foot with attenuated ligaments and comparing the alignment angles to the intact foot. We found that failure of any one of the ligaments led to overloading the remaining ligaments, except for the plantar naviculocuneiform, first plantar tarsometatarsal, and spring ligaments, where removing one led to unloading the other two. The combined attenuation of the plantar fascia, long plantar, short plantar, and spring ligaments significantly overloaded the deltoid and talocalcaneal ligaments. Isolated PTT rupture had no effect on foot alignment but did increase the force in the deltoid and spring ligaments. Moreover, increasing the force within the PTT to 30% of body weight was effective at restoring foot alignment during quiet stance, primarily through reducing hindfoot valgus and forefoot abduction as opposed to improving arch collapse. Our findings suggest that early intervention might be used to prevent the progression of deformity. Moreover, strengthening the PTT through therapeutic exercise might improve its ability to restore foot alignment.

show abstract

Rupture of the Posterior Tibial Tendon. Evaluation of Injury of the Spring Ligament and Clinical Assessment of Tendon Transfer and Ligament Repair*

Cited by 194 publications

References 8 publications

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Comparison of Foot Kinematics Between Subjects With Posterior Tibialis Tendon Dysfunction and Healthy Controls

Classifications in Brief: Johnson and Strom Classification of Adult-acquired Flatfoot Deformity

A computational model of force within the ligaments and tendons in progressive collapsing foot deformity

Contact Info

Product

Resources

About