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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 . [ 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]
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.
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).
Tendon transfers have higher chance to treat nerve palsy, and such transfers include posterior, anterior, and anteroposterior tibial tendon transfer. Peroneal nerve and its nerve branches need to be fixed from adherence to proximal fibula, which proximal fibula is about 3~5 cm. [ 14 ]
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
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 ...