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The Journal of Bone and Joint Surgery (American) 78:780-92 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Adult Acquired Flatfoot Deformity. Treatment of Dysfunction of the Posterior Tibial Tendon*{dagger}

MARK S. MYERSON, M.D.{ddagger}, BALTIMORE, MARYLAND

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons

The first 150 words of the full text of this article appear below.


   Introduction
 
Acquired flatfoot deformity caused by dysfunction of the posterior tibial tendon is a common clinical problem. Treatment, which depends on the severity of the symptoms and the stage of the disease, includes non-operative options, such as rest, administration of anti-inflammatory medication, and immobilization, as well as operative options, such as tendon transfer, calcaneal osteotomy, and several methods of arthrodesis.


   Anatomy and Pathophysiology
 
The posterior tibial muscle forms part of the deep posterior compartment of the calf. It originates from the proximal third of the tibia and the interosseous membrane and passes immediately posterior to the medial malleolus, where it changes direction acutely23. A groove in the posteromedial aspect of the distal part of the tibia holds the posterior tibial tendon but is not deep enough to keep the tendon from bow-stringing or dislocating after an injury45. The flexor retinaculum, which is adjacent to the medial malleolus, tethers the tendon and keeps . . . [Full Text of this Article]


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