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Related Experiment Videos

Flexible adult flatfoot: soft tissue procedures.

Jeremy L Walters1, Samuel S Mendicino1

  • 1West Houston Medical and Surgical Residency Program PMSR/RRA, West Houston Medical Center, 12121 Richmond Avenue, Suite 417, Houston, TX 77082, USA.

Clinics in Podiatric Medicine and Surgery
|July 2, 2014
PubMed
Summary

Posterior tibial tendon dysfunction (PTTD) treatment has evolved from solely soft tissue repair to include osseous procedures due to a better understanding of its complex biomechanics. Restoring soft tissues remains crucial for effective flatfoot repair.

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Area of Science:

  • Orthopedics
  • Foot and Ankle Surgery
  • Biomechanics

Background:

  • Posterior tibial tendon dysfunction (PTTD) was historically treated as a simple tendon rupture with soft tissue repair.
  • Current understanding recognizes PTTD as a complex condition involving muscle imbalance, leading to flatfoot, osteoarthritis, and peritalar subluxation.

Purpose of the Study:

  • To review the evolving understanding of posterior tibial tendon dysfunction (PTTD) pathomechanics.
  • To discuss the changing role of surgical interventions, including soft tissue and osseous procedures, in managing PTTD.

Main Methods:

  • Literature review of PTTD pathomechanics and surgical treatment evolution.
  • Analysis of the interplay between soft tissue and osseous components in PTTD deformity.
Keywords:
AnkleFlexor digitorumFlexor digitorum longusFootPes planusPosterior tibialPosterior tibial tendon dysfunction

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Main Results:

  • PTTD involves more than tendon rupture; it includes muscle imbalance contributing to significant foot deformities.
  • Surgical approaches have expanded to incorporate osseous procedures alongside soft tissue repair.

Conclusions:

  • Advancements in understanding PTTD pathomechanics have modified surgical strategies.
  • Soft tissue restoration remains a critical component in the surgical management of flatfoot deformities associated with PTTD.