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3.3 to 10% Posterior tibial tendon dysfunction is the dysfunction of the posterior tibial tendon . It is a progressive disease that has four stages [ 1 ] and is the most common cause of adult flatfoot .
In the case of posterior tibial tendon dysfunction causing flatfoot, sinus tarsi syndrome can also develop due to the disruption in the entire structure of the foot. [ 4 ] The condition is also thought to be caused by ankle/subtalar joint instability causing inflammation in the area.
Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. [2] The pain is typically worse with movement. [2] It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbow, golfer's elbow), wrist, hip, knee (jumper's knee, popliteus tendinopathy), or ankle (Achilles tendinitis).
Type 1: An os tibiale externum is a 2–3 mm sesamoid bone in the distal posterior tibialis tendon. Usually asymptomatic. Usually asymptomatic. Type 2 : Triangular or heart-shaped ossicle measuring up to 12 mm, which represents a secondary ossification center connected to the navicular tuberosity by a 1–2 mm layer of fibrocartilage or hyaline ...
The flexor digitorum longus runs along the medial posterior side of the lower leg and aids in flexions of the toes (apart from the big toe). The flexor digitorum longus muscle arises from the posterior surface of the body of the tibia, from immediately below the soleal line to within 7 or 8 cm of its lower extremity, medial to the tibial origin of the tibialis posterior muscle.
The tibialis posterior muscle originates on the inner posterior border of the fibula laterally. [2] It is also attached to the interosseous membrane medially, which attaches to the tibia and fibula. [2] The tendon of the tibialis posterior muscle (sometimes called the posterior tibial tendon) descends posterior to the medial malleolus. [2]
If non-invasive treatment measures fail, tarsal tunnel release surgery may be recommended. Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle.
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]