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Treatment of posterior tibial tendon dysfunction without flexor digitorum tendon transfer: a retrospective study of 34 patients.

Abstract
A retrospective study of patients who underwent gastrocnemius recession, double calcaneal osteotomy (Evans osteotomy and percutaneous calcaneal displacement osteotomy), and medial column fusion for the treatment of posterior tibial tendon dysfunction was conducted. The senior author performed the procedures between November 2002 and January 2009 on 34 patients who displayed at least Johnson and Strom stage II deformity and had undergone 12 months of failed conservative treatment. The coauthors evaluated the patients' radiographs before and after the operation. At a mean of 14 (range 3 to 44) months after surgery, radiographic measurements demonstrated statistically significant changes in the structural alignment of the feet. Based on our experience with these patients, we believe that a double calcaneal osteotomy combined with a gastrocnemius recession and stabilization of the medial column for the treatment of posterior tibial tendon dysfunction provides satisfactory correction, stability, and realignment of the foot. Furthermore, we feel that the use of flexor digitorum longus transfer, as well as triple arthrodesis, can be avoided without compromising the outcome when surgically treating posterior tibial tendon dysfunction.
AuthorsLawrence Didomenico, Dawn Y Stein, Mari Wargo-Dorsey
JournalThe Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2011 May-Jun Vol. 50 Issue 3 Pg. 293-8 ISSN: 1542-2224 [Electronic] United States
PMID21397524 (Publication Type: Journal Article)
CopyrightCopyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Topics
  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Health Status Indicators
  • Humans
  • Male
  • Metatarsophalangeal Joint (diagnostic imaging, pathology, surgery)
  • Middle Aged
  • Osteotomy (instrumentation, methods)
  • Posterior Tibial Tendon Dysfunction (diagnostic imaging, pathology, surgery)
  • Preoperative Care
  • Radiography
  • Retrospective Studies
  • Tendon Transfer (methods)
  • Tendons (transplantation)
  • Young Adult

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