Posterior tibial tendon dysfunction is a progressive injury, this can lead to limitations in mobility, significant pain, and weakness.
Early detection of posterior tibial tendon dysfunction may prevent operative means of repair; if left to progress, surgical reconstruction with osteotomy and arthrodesis becomes necessary.
Risk factors include: hypertension, obesity, diabetes, previous trauma, or steroid exposure.
The most commonly the cause for posterior tibial tendon dysfunction is degeneration due to repetitive loading causing microtrauma and progressive failure.
There are 4 stages to this injury:
Early stages: there may be pain, redness, warm and swollen. Symptoms may be present in running.
Later as the arch begins to flatten, there may be pain on the inside of the foot and ankle and the foot and toes begin to turn outward and the ankle rolls inward.
Advanced: the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle.
The tendon has deteriorated considerably and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.
Treatment for posterior tibial tendon dysfunction depends on whether patients need operative or non-operative treatment.
Non-invasive therapy, such as orthosis and physiotherapy are prevents damage to healthy surrounding tissue, but when non-operative treatment fails, surgical treatment is required.
Evidence suggests that early conservative intervention can significantly improve quality of life regarding disability, function, and pain.
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