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Biomechanical study on tibialis posterior tendon transfers
Clinical Orthopaedics and Related Research
|October 1, 1995
Summary
The interosseous route for tibialis posterior tendon transfer is more effective for dorsiflexion than the subcutaneous route. Tendon insertion site significantly impacts foot motion, with medial placement causing supination and lateral placement causing pronation.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Anatomy
Background:
- Anterior transfer of the tibialis posterior tendon is a surgical technique to improve dorsiflexion.
- Two primary routes exist: subcutaneous and interosseous.
Purpose of the Study:
- To compare the efficacy of the interosseous and subcutaneous routes for tibialis posterior tendon transfer.
- To determine the effect of tendon insertion site on ankle and foot motion.
Main Methods:
- Eleven cadaveric legs were used to simulate tibialis posterior tendon transfer.
- Tendon was routed anteriorly via interosseous membrane or subcutaneously.
- Tendon was inserted at varying metatarsal axes (1st through 5th).
- Ankle and foot motions were measured under applied tension.
Main Results:
- The interosseous route yielded greater dorsiflexion with less pronation compared to the subcutaneous route.
- Medial tendon insertion resulted in supination.
- Lateral tendon insertion resulted in pronation.
Conclusions:
- The interosseous route is superior for achieving dorsiflexion in tibialis posterior tendon transfers.
- Precise control of tendon insertion site is crucial for optimizing foot and ankle biomechanics post-surgery.