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Posterior tibial tendon rupture: a refined classification system.

Eric M Bluman1, Craig I Title, Mark S Myerson

  • 1Orthopaedic Foot and Ankle Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Avenue, Tacoma, WA 98431, USA. ericbluman@yahoo.com

Foot and Ankle Clinics
|June 15, 2007
PubMed
Summary

A refined classification system for posterior tibial tendon tears (PTTR) accounts for complex foot deformities. This updated system better addresses variations in deformity and guides potential treatments for each stage.

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Area of Science:

  • Orthopedics
  • Foot and Ankle Surgery
  • Musculoskeletal Disorders

Background:

  • The existing Johnson and Strom classification system for posterior tibial tendon tears (PTTR) from 1989 has limitations.
  • A wide spectrum of complex foot deformities associated with PTTR is not fully addressed by current systems.
  • Existing classifications lack sufficient flexibility for variations within treatment stages.

Purpose of the Study:

  • To present a refined classification system for posterior tibial tendon tears (PTTR).
  • To incorporate key elements of foot and ankle deformity into a new classification framework.
  • To provide stage-specific treatment recommendations for PTTR.

Main Methods:

  • Analysis of deformity components including ankle and hindfoot valgus, forefoot supination, forefoot abduction, and medial column instability.

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  • Development of a refined classification system based on these parameters.
  • Discussion of potential treatment strategies tailored to each stage of the refined classification.

    • Main Results:

    • A new classification system for PTTR has been developed.
    • The refined system accounts for a broader range of foot and ankle deformities.
    • Potential treatments are outlined for each identified stage of PTTR.

    Conclusions:

    • The proposed refined classification system offers a more comprehensive approach to PTTR.
    • This system better accommodates the complexity and variability of PTTR-related deformities.
    • The classification provides a foundation for more individualized and effective treatment planning for posterior tibial tendon tears.