Subtalar Arthroeresis in Posterior Tibial Tendon Dysfunction

2011 ◽  
Vol 18 (1) ◽  
pp. 55-59
Author(s):  
Sargon Konstantinovich Tamoev ◽  
N V Zagorodniy ◽  
V G Protsko ◽  
E M Sultanov ◽  
Z Kh Khamokov ◽  
...  
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
X Ray ◽  
Posterior Tibial ◽  
Study Results ◽  
Foot Function ◽  
American Orthopaedic ◽  
Foot Position

The purpose of the study was to evaluate the efficacy of subtalar arthroeresis for II stage tibial tendon dysfunction by Johnson and Storm classification. From November 2007 to August 2009, 18 patients with that pathology were operated on. After implantation of Kalix® II endorthesis the plasty of posterior tibial tendon was performed. The results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) scores system. After treatment average estimate by AOFAS increased from 47.2 before operation to 79.0 after surgery, pain index from 16.3 to 30.0, foot function from 28.7 to 41.6, foot position from 2.6 to 8.4. According to X-ray data the longitudinal arch angle decreased by 14.3° at an average and talar-calcaneal angle by 8°. Study results showed that technique of subtalar arthrodesis was effective enough for correction of flat foot resulted from II stage posterior tibial tendon dysfunction. Combination of that technique with tendon plasty ensured the full-value reconstruction of the foot.

scholarly journals Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus

2019 ◽  
Vol 5 (1) ◽  
pp. 60-65
Author(s):  
Henry Ricardo Handoyo ◽  
Andryan Hanafi Bakri ◽  
Andri Primadhi Primadhi
Keyword(s):  
Platelet Rich Plasma ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Left Ankle ◽  
History Of

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

Foot and ankle functions and deformities focus on posterior tibial tendon dysfunction using magnetic resonance imaging in patients with rheumatoid arthritis

2021 ◽  
Author(s):  
Takeshi Mochizuki ◽  
Yuki Nasu ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ryo Hiroshima ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pitch Angle ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Posterior Tibial Tendon Dysfunction ◽  
First Metatarsal ◽  
Posterior Tibial ◽  
Metatarsal Angle

ABSTRACT Objectives Posterior tibial tendon dysfunction (PTTD) affects the support of the medial longitudinal arch and stability of the hindfoot. The purpose of this study was to assess the relationships of PTTD with foot and ankle functions and foot deformities in patients with rheumatoid arthritis (RA). Methods A total of 129 patients (258 feet) who underwent magnetic plain and contrast-enhanced magnetic resonance imaging were enrolled in this study. Positive magnetic resonance imaging findings were defined as tenosynovitis and incomplete and complete rupture of the posterior tibial tendon. Foot and ankle functions were assessed using the Japanese Society for Surgery of the Foot standard rating system for the RA foot and ankle scale (JSSF-RA) and self-administered foot evaluation questionnaire. Plain radiographs were examined for the hallux valgus angle, first metatarsal and second metatarsal angle, lateral talo-first metatarsal angle, and calcaneal pitch angle. Results PTTD was associated with motion in the JSSF-RA (p = .024), activities of daily living in JSSF-RA (p = .017), and pain and pain-related factors in the self-administered foot evaluation questionnaire (p = .001). The calcaneal pitch angle was significantly lower in the feet with PTTD than in those without PTTD (median: 16.2° vs. 18.0°; p = .007). Conclusions The present study shows that PTTD was associated with foot and ankle functions and flatfoot deformity. Thus, a better understanding of PTTD in patients with RA is important for the management of foot and ankle disorders in clinical practice.

Bending, Torsional, and Pullout Strength of Compression Screws in Cadaver Foot and Ankle Specimens

2008 ◽  
Author(s):  
Ferris M. Pfeiffer ◽  
Paul S. Shurnas ◽  
Dennis L. Abernathie ◽  
James A. Ronan
Keyword(s):  
Bone Healing ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Pullout Strength ◽  
Posterior Tibial Tendon Dysfunction ◽  
Bone Screw ◽  
Charcot Neuroarthropathy ◽  
Posterior Tibial ◽  
Small Bones ◽  
The Stability

It has been well supported in the literature that using compression screws is the preferred method to achieve fixation of an arthrodesis [1, 2]. Indications for isolated subtalar arthrodesis include trauma, arthritis, talocalcaneal coalition, adult acquired flatfoot, posterior tibial tendon dysfunction, and Charcot neuroarthropathy [3, 4]. With the increase in bone screw shapes and designs, there is a desire to achieve the best compression generated by a type of screw so as to promote excellent bone healing and outcome for the patient; this will also allow the stability of the construct achieved by the screw and its placement to be determined. As indicated by Wheeler, et. al.[5] screw choice, compression, stability and loading can be very important when it comes to healing of fractures in small bones.

Orthotic treatment for stage I and II posterior tibial tendon dysfunction (flat foot): A systematic review

2020 ◽  
pp. 026921552096012
Author(s):  
Isabel Gómez-Jurado ◽  
José María Juárez-Jiménez ◽  
Pedro V Munuera-Martínez
Keyword(s):  
Risk Of Bias ◽  
Stage I ◽  
Cochrane Library ◽  
Posterior Tibial Tendon ◽  
Foot Orthoses ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Exercise Programmes ◽  
Orthotic Treatment

Objective: To investigate whether orthotic treatment is effective for the treatment of posterior tibial tendon dysfunction stages I and II (flat foot). Data Sources: Five databases (PubMed, Scopus, PEDro, SPORTDiscus and The Cochrane Library) were searched for potential RCTs from their inception until August 2020. Review Methods: Only randomised controlled trials (RCT) that included subjects diagnosed with posterior tibial dysfunction in the initial stage and treated with orthotic treatments were selected. The outcomes assessed were whatever symptom related to posterior tibial tendon dysfunction stage I and II. Included RCTs were appraised using the Cochrane collaboration risk of bias tool. Results: Four RCT articles and 186 subjects were included. 75% were at high risk of bias for blinding of participants and personnel. Three different types of conservative treatment were used in the studies: foot/ankle-foot orthoses, footwear and stretching /strengthening exercises. Foot orthoses, together with exercise programmes, seemed to improve the effect of orthotic treatment. Foot orthoses with personalised internal longitudinal arch support were more effective than flat insoles or standard treatments in reducing pain. Conclusions: The use of orthotic treatment may be effective in reducing pain in the early stages of posterior tibial tendon dysfunction. Further research is needed into individualised orthotic treatment and high-intensity monitored exercise programmes.

Foot and ankle kinematics in patients with posterior tibial tendon dysfunction

2008 ◽  
Vol 27 (2) ◽  
pp. 331-339 ◽  
Author(s):  
Mary Ellen Ness ◽  
Jason Long ◽  
Richard Marks ◽  
Gerald Harris
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
Ankle Kinematics

scholarly journals Effects of Custom-mold Insole by Medial Heel Skive Technique on Physical Function in Flexible Flat Foot

2021 ◽  
Vol 19 (2) ◽  
pp. 181-188
Author(s):  
Fahimeh Bakhtiari ◽  
◽  
Mahmood Bahramizadeh ◽  
Zahra Safaeepour ◽  
Mohsen Vahedi ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Physical Function ◽  
Daily Living ◽  
Nonparametric Tests ◽  
Foot And Ankle ◽  
Flat Foot ◽  
Study Results ◽  
Flat Feet ◽  
Foot Function ◽  
Orthotic Insoles

Objectives: Flexible Flat Foot (FFF), a common foot deformity decreasing medial longitudinal arch height is often comorbid with subtalar joint pronation causing physical activity difficulties in this population. Among the orthotic insoles prescribed for improving foot function, foot orthoses with medial heel skive technique have a limited research background. The present study aimed to investigate the effects of the custom-mold insole with medial heel skive technique on physical function in FFF. Methods: Eighteen adults with FFF from the University of Social Welfare and Rehabilitation Sciences students and staff participated in this study. Custom-Mold insole with medial heel skive was fabricated for all research participants. Physical function in the activities of daily living and sports was assessed by the Foot and Ankle Ability Measure (FAAM), Activities of Daily Living (ADL) subscale (ADL-FAAM), and SPORT-FAAM questionnaires at the beginning of the study and 6 weeks after. Paired Samples t-test and nonparametric tests were used to compare the collected results. Results: After 6 weeks of using the insole with medial heel skive technique, scores in both ADL and SPORTS activities were significantly improved. Discussion: Foot function improvement was not found in all of the studies assessing foot function in flat feet after using different orthotic insoles, by different questionnaires or other systems. In this study, foot and ankle function was significantly improved per FAAM questionnaire- which had highly limited use in orthotic interventions in flat feet population- using medial heel skive technique; however, further studies are required to accentuate medial heel skive technique effect on flat feet function by comparing this technique with other positive cast modifications to control the flat foot. According to the present study results, custom-mold insole with medial heel skive may improve physical function in FFF and can be prescribed in this group.

scholarly journals Tendoscopic treatment of acute posterior tibial tendon dysfunction: case report

2021 ◽  
Vol 15 (3) ◽  
pp. 265-268
Author(s):  
Daniel Saraiva ◽  
Markus Knupp ◽  
André Sá Rodrigues ◽  
Tiago Mota Gomes ◽  
Xavier Martin Oliva
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Rheumatoid Patient ◽  
Posterior Tibial ◽  
Foot Arch ◽  
Magnetic Resonance Imaging Mri

We present a case of a rheumatoid patient presenting with acute signs of posterior tibial tendon dysfunction (PTTD). Magnetic resonance imaging (MRI) results were inconclusive regarding the grade of posterior tibial tendon (PTT) tear. We performed posterior tibial tendoscopy, releasing all tendon adherences, and accomplished complete synovectomy. By the end of the procedure, we observed PTT integrity, normal excursion, and mild tendinosis. At 24-month follow-up, the Visual Analog Scale for pain (VAS-Pain) decreased from 9 (preoperatively) to 1. The Foot and Ankle Outcome Score (FAOS) increased from 16% (preoperatively) to 94%. Clinically, the patient had a symmetric bilateral heel rise test and no pain over the course of the PTT. A standard radiographic assessment demonstrated a normal foot arch and hindfoot alignment. This report illustrates how posterior tibial tendoscopy can simultaneously provide accurate diagnosis and surgically address acute PTTD on a rheumatoid patient, relieving symptoms and improving midterm clinical scores. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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