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The position of the tendon is also thought to contribute, as it makes a sharp turn around the medial malleolus, putting a lot of tension on the tendon. Other proposed causes include constriction underneath the flexor retinaculum , talus abnormalities, osteoarthritis , and preexisting flatfoot . [ 2 ]
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]
More rarely, excessive physical activity and other forms of foot trauma/chronic ankle injury are thought to be the cause. [1] [6] 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]
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.
It is composed of a thin muscle belly and a long thin tendon. While not as thick as the achilles tendon, the plantaris tendon (which tends to be between 30–45 centimetres (12–18 in) in length) is the longest tendon in the human body. Not including the tendon, the plantaris muscle is approximately 5–10 centimetres (2.0–3.9 in) long and ...
Injury to the artery behind the knee, compartment syndrome [3] [4] Types: Anterior, posterior, lateral, medial, rotatory [4] Causes: Trauma [3] Diagnostic method: Based on history of the injury and physical examination, supported by medical imaging [5] [2] Differential diagnosis: Femur fracture, tibial fracture, patellar dislocation, ACL tear ...
Common nerve injuries that are treated with tendon transfer surgery are spinal cord, radial nerve, ulnar nerve, or median nerve injury. Tendon transfers have higher chance to treat nerve palsy, and such transfers include posterior, anterior, and anteroposterior tibial tendon transfer.
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]
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