Spontaneous Rupture of the Posterior Tibial Tendon

Kettelkamp, Donald B.; Alexander, Harold H.

doi:10.2106/00004623-196951040-00014

Cited by 134 publications

(30 citation statements)

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“…Adult acquired flatfoot deformity is a common disorder characterized by collapse of the medial longitudinal arch, forefoot abduction, and hindfoot eversion . Posterior tibialis tendon dysfunction (PTTD) is associated with adult acquired flatfoot deformity in both a chronic and a traumatic fashion, although the exact role of the failure of the posterior tibialis tendon (PTT) is not completely known. The valgus deformity resulting from collapse of medial supporting ligaments leads to increased eversion of the calcaneus due to the position of the Achilles tendon lateral to the axis of rotation of the subtalar joint .…”

mentioning

confidence: 99%

Comparison of transfer sites for flexor digitorum longus in a cadaveric adult acquired flatfoot model

Vaudreuil

Ledoux

Roush

et al. 2013

Journal Orthopaedic Research

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Posterior tibialis tendon (PTT) dysfunction (PTTD) is associated with adult acquired flatfoot deformity. PTTD is commonly treated with a flexor digitorum longus (FDL) tendon transfer (FDLTT) to the navicular (NAV), medial cuneiform (CUN), or distal residuum of the degraded PTT (rPTT). We assessed the kinetic and kinematic outcomes of these three attachment sites using cadaveric gait simulation. Three transfer locations (NAV, CUN, rPTT) were tested on seven prepared flatfoot models using a robotic gait simulator (RGS). The FDLTT procedures were simulated by pulling on the PTT with biomechanically realistic FDL forces (rPTT) or by pulling on the transected FDL tendon after fixation to the navicular or medial cuneiform (NAV and CUN, respectively). Plantar pressure and foot bone motion were quantified. Peak plantar pressure significantly decreased from the flatfoot condition at the first metatarsal (NAV) and hallux (CUN). No difference was found in the medial-lateral center of pressure. Kinematic findings showed minimal differences between flatfoot and FDLTT specimens. The three locations demonstrated only minimal differences from the flatfoot condition, with the NAV and CUN procedures resulting in decreased medial pressures. Functionally, all three surgical procedures performed similarly.

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mentioning

confidence: 99%

Comparison of transfer sites for flexor digitorum longus in a cadaveric adult acquired flatfoot model

Vaudreuil

Ledoux

Roush

et al. 2013

Journal Orthopaedic Research

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“…1,22,35,36,38 There are several studies describing not only the anatomy and function, but also the management, of rupture of the posterior tibial tendon. 21,30,31,35,36,38,39,44,48 Little is known about those factors which may be associated with or predispose patients to rupture of the posterior tibial tendon. One study indicates a higher frequency of rupture in women over the age of 40.…”

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confidence: 99%

Possible Epidemiological Factors Associated with Rupture of the Posterior Tibial Tendon

1992

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Rupture of the posterior tibial tendon has been postulated to occur, in part, as a result of degenerative changes to the tendon. This possibility was examined by a review of 67 patients (average age 57 years) diagnosed with rupture of the posterior tibial tendon. Forty-five of the 67 patients (60%) had one or more of the following positive medical histories: (1) hypertension, (2) obesity, (3) diabetes mellitus, (4) previous surgery or trauma about the medial aspect of the foot, or (5) steroid exposure. Thirty-five patients (52%) had either hypertension, diabetes mellitus, or obesity. A statistical correlation was demonstrated between rupture of the posterior tibial tendon and obesity (P = .005) and to a lesser extent hypertension (P = .025). These disorders have been uniformly associated with an acceleration of the degenerative processes associated with aging, commonly via an acceleration of microvascular and macrovascular diseases. An additional vascular risk is implicated by the known zone of hypovascularity of the posterior tibial tendon and risk of rupture secondary to systemic or local injections of corticosteroids. The prevalence of posterior tibial tendon rupture parallels the degenerative processes of aging, hypertension, diabetes mellitus, and obesity. Additionally, the effects of corticosteroids and local surgical procedures may further be associated with local vascular impairment and eventual rupture.

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“…According to the literature, post-traumatic rupture of the tibialis posterior tendon always requires early surgical repair, in order to regain the function of the tendon and avoid progression to a plano-valgus foot [7,8,13]. In fact, Mueller, and Kupcha and Shan have reported acquired flatfoot deformity secondary to untreated tibialis posterior rupture [14,15].…”

Section: Discussionmentioning

confidence: 99%

Rupture of the tibialis posterior tendon in a closed ankle fracture: a case report

et al. 2008

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Rupture of the tibialis posterior tendon may occur during a trauma in pronation-external rotation of the foot or, less commonly, during a direct trauma of the ankle. When an isolated fracture of the medial malleolus is present, it is more likely that a direct trauma has occurred. A 36-year-old man with a non-displaced medial malleolar fracture was evaluated. Repair of the tendon and reduction of the fracture were performed. Twenty-four months after the operation, the fracture was completely healed, the patient was asymptomatic, he had a normal ankle range of motion, and the function and strength of the tibialis posterior tendon were equal to those on the contralateral side. Early surgical repair of the tibialis posterior tendon combined with malleolar fracture reduction is recommended to avoid progression to a plano-valgus foot.

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Spontaneous Rupture of the Posterior Tibial Tendon

Cited by 134 publications

References 0 publications

Comparison of transfer sites for flexor digitorum longus in a cadaveric adult acquired flatfoot model

Comparison of transfer sites for flexor digitorum longus in a cadaveric adult acquired flatfoot model

Possible Epidemiological Factors Associated with Rupture of the Posterior Tibial Tendon

Rupture of the tibialis posterior tendon in a closed ankle fracture: a case report

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