This is a condition that affects the posterior tibial tendon. The particular structure begins as a muscle deep in the leg and continues as a tendon into the ankle and foot where it attaches itself to the inner side of the arch of the foot. This tendon's main function is to maintain the stability of the inner part of the foot as well as the arch of the foot. It stabilizes your arch. Various problems can develop with the posterior tibial tendon. This can range from mild inflammation, a more extensive inflammation, a partial tear, or even a complete rupture. In cases where the posterior tibial tendon is ruptured or severely damaged, the affected foot would be extremely flat compared to the opposite limb. In cases of moderate tendon change some degree of loss of arch height may be visible to the patient or to the patient’s family and an awkward gait can ensue. Pain along the inner side of the ankle as well as the inner side of the arch may develop. The patient oftentimes needs to limp in order to be able to function. The posterior tibial tendon problems have been labeled posterior tibial tendon dysfunction. This is a progressive problem that does require definitive treatment.
How is Posterior Tibial Tendon Dysfunction Treated?
Conservative treatment often involves a combination of therapies. This can range from anti inflammatory medications, orthotics, alterations of shoe gear, and ankle bracing. Custom ankle foot orthotics may be needed. The type of therapy is dependent on the patients medical status and the degree of deformity present. This problem is often progressive. If the condition is unable to be aided by conservative therpy, or if the condition is more advanced-then surgical treatment myay be recommended. The appropriate surgical procedure is based on several factors-depending upon the grade of posterior tibial dysfunction that exists. Most surgical treatemnt involves a combination of tendon lengthening, transfers, and bone cutting operations. The goal is to reconstruct the foot and allow better function with better positioning. In more severe cases that have progressed to arthritic joint problems -then a fusion or arthrodesis would be the procedure of choice.One such procedure is called a triple arthrodesis. Ulilizing modern contemporary techniques in surgery have allowed us to effectively treat these patients and allow them to return to normal activities with improved function.