First ray mobility and posterior tibial tendon dysfunction (PTTD) in persons with flatfoot: A case control study

Area of Science:

• Orthopedics
• Biomechanics
• Podiatry

Background:

• Posterior tibial tendon dysfunction (PTTD) often presents with flat feet.
• First ray mobility has been theorized as a factor in PTTD, but many flat-footed individuals are asymptomatic.
• Controlling for foot type is crucial when investigating PTTD-related factors.

Purpose of the Study:

• To determine if first ray mobility differs between flat-footed individuals with and without PTTD symptoms.
• To investigate the association between first ray mobility and PTTD in a flat-footed population.
• To test the hypothesis that PTTD patients exhibit greater first ray mobility than asymptomatic controls.

Main Methods:

• Recruited 32 flat-footed subjects (16 with PTTD, 16 asymptomatic controls matched for age, sex, BMI).
• Assessed first ray mobility via subjective classification (stiff, normal, hypermobile) and maximum dorsal displacement measurement.
• Utilized Mann-Whitney U test to compare groups.

Main Results:

• Subjective joint mobility classifications were similar between PTTD and control groups (38% normal in both).
• No statistically significant difference in first ray displacement was observed between PTTD patients and asymptomatic controls (median 6.00 mm in both groups).

Conclusions:

• First ray mobility is not associated with PTTD in individuals with flat feet.
• Clinicians should consider factors beyond first ray mobility when assessing PTTD symptoms in flat-footed patients.