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Advances in biomechanics of posterior tibial tendon dysfunction and flatfoot deformity

Introduction

The objective of this presentation is to highlight the clinical and laboratory-based research related to posterior tibial tendon dysfunction (PTTD).

Methods and results

  • Defining the flatfoot: clinical, foot pressure, radiologic

  • Critical evaluation of flatfoot deformity: in vitro

  • How often does the flatfoot occur?

  • Normal arch development

  • Why is the flatfoot a problem?

  • Why does the flatfoot occur?

  • 1. Effects of weightbearing [1]

  • 2. Lost of static support [2]

  • 3. Loss of dynamic support [3]

  • 4. Anatomic predisposition

  • 5. Joint subluxation

  • Causes of flatfoot in adults

  • 1. Posterior tibial tendon dysfunction (PTTD)

  • 2. Arthritis: Midfoot, hindfoot, ankle

  • 3. Hypermobile flatfoot

  • 4. Neuropathic arthropathy

  • 5. Fracture malunion

  • 6. Inflammatory arthropathy

  • 7. Peroneal spastic flatfoot

  • 8. Neuromuscular disorder

  • 9. Other

  • PTTD etiology

  • PT muscle, tendon anatomy

  • PT function

  • PT muscle activity during gait

  • Factors predisposing to PTTD

  • PT gliding resistance

  • PT pathoanatomy

  • Natural history of PTTD

  • PTTD evaluation: symptoms, signs

  • Investigative studies

  • Gait analysis in PTTD patients

  • Simulated walking: Normal, PTTD [4]

  • PTTD treatment

  • PTTD treatment results

  • Failures, complications

Conclusion

  • Current recommendations

References

  1. 1.

    Kitaoka HB: Foot Ankle Int. 1995, 16: 492-9.

  2. 2.

    An KN: J Biomech. 1988, 21: 613-20. 10.1016/0021-9290(88)90225-4.

  3. 3.

    Kim KJ: J Musculoskeletal Res. 2001, 5 (2): 113-21.

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Acknowledgements

Kai-Nan An, PhD; Kenton R Kaufman, PhD

Author information

Correspondence to Harold B Kitaoka.

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Keywords

  • Arthritis
  • Muscle Activity
  • Arthropathy
  • Current Recommendation
  • Investigative Study