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The Cobb procedure for stage II posterior tibial tendon dysfunction
Clinics in Podiatric Medicine and Surgery
|September 2, 1999
Summary
A modified Cobb procedure using the tibialis anterior tendon offers similar results to flexor digitorum longus transfer for posterior tibial tendon dysfunction (PTTD). This technique avoids sacrificing functional muscles and reduces potential complications.
Area of Science:
- Orthopedic surgery
- Foot and ankle reconstruction
Background:
- Posterior tibial tendon dysfunction (PTTD) often requires surgical intervention.
- Flexor digitorum longus (FDL) transfer is a common but functionally sacrificing procedure for PTTD repair.
Purpose of the Study:
- To evaluate a modified Cobb procedure for PTTD repair.
- To assess the efficacy of tibialis anterior (TA) tendon tenodesis as an alternative to FDL transfer.
Main Methods:
- A modified Cobb procedure involving split TA tendon tenodesis was performed.
- The modification avoids creating a bone tunnel through the navicular or medial cuneiform.
Main Results:
- The modified Cobb procedure provides effective augmentation for the posterior tibial tendon.
- Similar functional outcomes were achieved compared to FDL transfer without sacrificing muscle function.
Conclusions:
- The modified Cobb procedure is a successful treatment for PTTD.
- It offers robust autograft augmentation without compromising other tendon functions, leading to predictable outcomes.