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J Foot Ankle Surg 2020 May - Jun;59(3):469-478

Orthopaedic Surgeon, Foot and Ankle Department, Clínica Bazterrica, Buenos Aires, Argentina.

Patients with acquired flatfoot deformity due to isolated injury of the spring ligament, with healthy posterior tibialis tendon, are rarely identified. Between December 2004 and September 2011 (6 years and 9 months), we treated 10 patients with acquired flatfoot deformity due to spring ligament injury without tibialis posterior tendon tear. One patient (10%) was lost to follow-up. Read More

Am J Phys Med Rehabil 2020 Mar 18. Epub 2020 Mar 18.

Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ Burke Rehabilitation Hospital, White Plains, NY, Arthur S. Abramson Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Montefiore Health System1 Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA and University of Hawaii School of Medicine, Honolulu, Hawaii, USA. Department of Physical Medicine & Rehabilitation, VA New Jersey Health Care System, East Orange, NJ.

Despite the high incidence of foot and ankle injuries and their biomechanical importance to more proximal joints, the foot and ankle are some of the most daunting and underemphasized musculoskeletal structures in medical training. This study used musculoskeletal ultrasound to identify a knowledge gap in Physical Medicine and Rehabilitation (PM&R) residents in foot and ankle surface anatomy palpation and to determine if senior residents had higher examination performance compared to more junior residents. PM&R residents at different levels of training were tested cross-sectionally and palpation accuracy was compared by class year. Read More

Br J Radiol 2019 Dec 17;92(1104):20190722. Epub 2019 Oct 17.

Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK.

Objective: It has been stated that the distal 1-2 cm of the tibialis posterior tendon (TPT) does not have a tendon sheath but rather a paratenon, and that any fluid seen around this segment on ankle MRI is considered to represent paratendonitis. The prevalence and clinical significance of isolated TPT paratendonitis diagnosed on ankle MRI is unknown. This study aims to correlate the presence of isolated distal segment TPT paratendonitis on ankle MRI, with the presence or absence of medial midfoot pain. Read More

Br J Radiol 2019 Dec 11;92(1104):20190221. Epub 2019 Oct 11.

Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000 Vail, Colorado 81657, United States.

Objective: Early detection of tibialis posterior tendon changes and appropriate intervention is necessary to prevent disease progression to flat-foot deformity and foot/ankle dysfunction, and the need for operative treatment. Currently, differentiating between early-stage tibialis posterior tendon deficiency patients who will benefit from conservative more aggressive treatment is challenging. The objective of this work was to establish a quantitative MRI T2* mapping method and subregion baseline values in the tibialis posterior tendon in asymptomatic ankles for future clinical application in detecting tendon degeneration. Read More

Radiol Case Rep 2019 Sep 17;14(9):1144-1147. Epub 2019 Jul 17.

Department of Radiology, University of Washington, 4245 Roosevelt Way N.E., Seattle, WA 98105, USA.

Medial flexor retinaculum injuries are not uncommon, but medial flexor retinaculum periosteal avulsion injuries are rare. This patient sustained a medial flexor retinaculum tear readily characterized at computed tomography by an associated proximal retinacular avulsion fracture from the posteromedial tibia. Medial flexor retinaculum injury is often also associated with superficial deltoid pathology and/or medial malleolar fracture. Read More

J Foot Ankle Surg 2019 Sep 29;58(5):995-1001. Epub 2019 May 29.

Department of Podiatric Surgery and Medicine at Mount Sinai Beth Israel Medical Center, New York, NY.

Tibialis posterior (TP) tendon ruptures are common after ankle injuries, degenerative processes, or biomechanical instability. The TP tendon decelerates the subtalar joint pronation and internal rotation of the leg during the contact phase. It also plantarflexes and inverts the foot on the leg during the static phase of gait. Read More

J Med Case Rep 2018 Nov 23;12(1):348. Epub 2018 Nov 23.

Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.

Background: Traumatic dislocation of the tibialis posterior tendon at the ankle is a rare injury. Some of these cases are misdiagnosed as ankle sprains and are not treated properly. In addition, because the conservative treatment is not as effective as the surgical treatment, it is essential that patients be diagnosed early so that proper surgical treatment can be performed. Read More

J Foot Ankle Surg 2019 Jul 15;58(4):647-652. Epub 2018 Nov 15.

Surgeon, Department of Orthopedic Surgery, Sports Medicine, Bellevue University Medical Center, Mansourieh, Lebanon.

We report the case of a 32-year-old basketball player who presented with an acute flatfoot deformity after performing a unipodal power jump. Rupture of the posterior tibial tendon within the foot was diagnosed and then treated by hamstring tendon transfer combined with application of autologous biologic preparations. The functional outcome at 18 months was good. Read More

J Ultrasound Med 2019 Apr 12;38(4):917-926. Epub 2018 Sep 12.

School of Health Sciences, University of Salford, Salford, UK.

Objective: Ankle sprains constitute approximately 85% of all ankle injuries, and up to 70% of people experience residual symptoms. While the injury to ligaments is well understood, the potential role of other foot and ankle structures has not been explored. The objective was to characterize and compare selected ankle structures in participants with and without a history of lateral ankle sprain. Read More

J Foot Ankle Surg 2018 Nov - Dec;57(6):1267-1271. Epub 2018 Jul 13.

Professor, Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan.

Dislocation of the tibialis posterior tendon (PTT) is a rare traumatic injury, and treatment is often delayed. Conservative treatment is ineffective for recurrent dislocation of the PTT; however, a reference standard procedure has not yet been established. In the present case report, we describe an innovative pseudo-pouch closing procedure with suture tape and a suture anchor for recurrent PTT dislocation. Read More

Foot Ankle Int 2018 08 11;39(8):984-989. Epub 2018 Apr 11.

2 Orthopedic Foot and Ankle Center, Westerville, OH, USA.

Background: The center-center technique for syndesmosis fixation has been described as an improved and reliable technique for proper reduction of the syndesmosis during ankle fracture repair. Concurrently, the use of flexible fixation with a suture button is becoming an established means of syndesmosis stabilization. The purpose of this cadaveric study was to assess for medial structure injury during the placement of a suture button using the center-center technique for ankle syndesmosis repair at 3 insertion intervals. Read More

Foot Ankle Int 2018 04 16;39(4):433-442. Epub 2018 Feb 16.

3 Clinique de l'Union, Ankle and Foot Surgery Center, Saint-Jean, France.

Background: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data. Read More

Foot Ankle Int 2018 06 15;39(6):712-719. Epub 2018 Feb 15.

1 Department of Orthopedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea.

Background: Selective soft tissue release (SSTR), which includes a combination of abductor hallucis, tibialis posterior, and Achilles lengthening, has been used in patients with recurrent clubfoot deformity after Ponseti treatment. The aim of this study was to investigate the prognostic factors for recurrence of clubfoot deformity after SSTR.

Methods: Consecutive patients with idiopathic clubfoot and residual or recurrent deformity after Ponseti treatment underwent SSTR between 2005 and 2013. Read More

Foot Ankle Surg 2018 Oct 21;24(5):374-382. Epub 2017 Jun 21.

Clinique de l'Union, Ankle and Foot Surgery Center, Boulevard de Ratalens, 31240 Saint-Jean, France. Electronic address:

Background: Tendoscopy has been proposed in treating several conditions affecting tendons around the ankle. We reviewed literature to investigate the efficacy of Achilles, peroneal and tibialis posterior tendoscopy.

Methods: Following the PRISMA checklist, the Medline, Scopus and EMBASE databases were searched, including studies reporting patients affected by disorders of Achilles, peroneal and tibialis posterior tendons and treated by tendoscopy (or tendoscopic-assisted procedures). Read More

Clin Biomech (Bristol, Avon) 2018 01 3;51:10-16. Epub 2017 Nov 3.

Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China. Electronic address:

Background: Posterior tibial tendinopathy is a challenging foot condition resulting in pes planus, which is difficult to diagnose in the early stage. Prior to the deformity, abnormal internal load transfer and soft tissue attenuation are anticipated. The objective of this study was to investigate the internal load transfer and strain of the ligaments with posterior tibial tendinopathy, and the implications to pes planus and other deformities. Read More

Foot Ankle Clin 2017 Dec 27;22(4):665-676. Epub 2017 Sep 27.

Foot and Ankle Division, Department of Orthopedic Surgery, Duke University Medical Center, 2301 Erwin Road, Box 3000, Durham, NC 27710, USA. Electronic address:

The development of tendinitis and tendinopathy is often multifactorial and the result of both intrinsic and extrinsic factors. Intrinsic factors include anatomic factors, age-related factors, and systemic factors, whereas extrinsic factors include mechanical overload and improper form and equipment. Although tendinitis and tendinopathy are often incorrectly used interchangeably, they are in 2 distinct pathologies. Read More

Foot Ankle Spec 2017 Oct 21;10(5):480-483. Epub 2017 Mar 21.

Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, California.

Introduction: Flexor tendon dislocation from the flexor tendon groove posterior of the medial malleolus has been previously described, and may be difficult to diagnose initially, but is amendable to surgical treatment with good outcomes. We present a unique case of unilateral dislocation of the posterior tibialis and flexor digitorum longus tendons with contralateral flexor digitorum longus subluxation that was treated surgically with a good outcome.

Case Presentation: A 37-year-old active duty male sustained a dislocation and subluxation of the flexor tendons bilaterally after a forced dorsiflexion injury. Read More

Foot Ankle Int 2017 Nov 1;38(11):1267-1270. Epub 2017 Sep 1.

2 Orthopedics Department, Meir Medical Center, Kfar Saba, Israel.

Background: Harvesting of the flexor digitorum longus (FDL) or the flexor hallucis longus (FHL) is a procedure used when tendon transfer is needed. It is commonly used in tibialis posterior reconstruction and Achilles tendon reconstruction. Harvesting of these tendons is sometimes difficult and time-consuming. Read More

J Foot Ankle Surg 2017 Nov - Dec;56(6):1288-1291. Epub 2017 Aug 1.

Orthopedics and Traumatology Surgeon/Specialist, Turan & Turan Bone and Joint Surgery Clinic, Osmangazi, Bursa, Turkey.

Several serious complications can occur after talar neck fractures. However, these fractures are extremely rare in children. We present a pediatric low-energy Hawkins type III fracture-dislocation that had excessive displacement accompanied by neurovascular and tendon entrapment. Read More

J Foot Ankle Surg 2017 Jul - Aug;56(4):889-893

Assistant Professor, Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY; Assistant Professor, Department of Orthopedic Surgery, NYU Langone Medical Center, New York, NY.

Irreducible ankle fractures are a relatively rare phenomenon. We present a case of a pronation abduction-type ankle fracture that was irreducible in the emergency room despite sedation. The patient was taken to the operating room, where the posterior tibialis tendon and retinaculum, deltoid ligament, and anteromedial capsule were found to be trapped within the joint. Read More

J Foot Ankle Surg 2017 Sep - Oct;56(5):1109-1113. Epub 2017 May 27.

Orthopaedic Surgeon, Department of Orthopaedics, Auckland City Hospital, Auckland, New Zealand.

Open ankle dislocations without fracture are rare injuries. Dislocation or interposition of adjacent tendons are a rare associated feature of ankle fracture-dislocation. We report an extremely unusual case of open ankle dislocation without fracture with concurrent tibialis posterior tendon interposition through the interosseous space that was detected incidentally on computed tomography. Read More

J Foot Ankle Surg 2017 May - Jun;56(3):697-701

Professor of Surgery, Orthopedic Foot & Ankle and Sports Medicine, Dalhousie University & Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada.

Irreducible ankle fracture-dislocations are very rare entities. The present case report demonstrates an unusual finding of tibialis posterior and flexor digitorum longus tendons interposed in the tibiofibular joint impairing successful closed reduction of ankle fracture-dislocation. A 45-year-old patient presented with a bimalleolar pronation-external rotation ankle fracture-dislocation after a motorcycle accident. Read More

Foot Ankle Spec 2017 Dec 25;10(6):572-577. Epub 2017 Apr 25.

Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, Morgantown, West Virginia.

Ankle fractures with an associated posterior tibialis tendon (PTT) rupture are rare injuries and have only been described in a number of case reports. These prior reports include patients that had an open fracture and/or an associated medial malleolar fracture component. In this unique case report, we present a patient that sustained a closed bimalleolar-equivalent ankle fracture/dislocation without medial malleolar involvement which was irreducible due to a PTT rupture and subsequent distal segment interposition in the tibiotalar joint. Read More

Foot Ankle Int 2017 Jul 11;38(7):752-759. Epub 2017 Apr 11.

2 Reno Orthopaedic Clinic, Reno, Nevada, USA.

Background: Traumatic tears of the tibialis posterior (TP) tendon following an ankle sprain are rare. The purpose of this study was to report our case series of TP tendon tears following an ankle sprain.

Methods: Patients with persistent TP tendon pain after an ankle sprain were retrospectively identified over a 4-year period and reviewed. Read More

J Foot Ankle Surg 2017 May - Jun;56(3):656-665. Epub 2017 Feb 22.

Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa; Assistant Director, The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa.

Tibialis posterior tendon dislocation is a rarely described entity that is easily missed, resulting in delayed diagnosis and treatment. A review of the English published data on the topic showed inconsistency in the reporting of injuries and surgical management techniques, leading us to describe a novel classification system to guide treatment and future reporting. We also describe a case of tibialis posterior tendon dislocation in a professional volleyball player and our surgical technique for correction, including retromalleolar groove deepening. Read More

J Orthop Trauma 2017 Jul;31(7):375-379

*Department of Orthopedic Surgery, Vanderbilt University, Nashville, TN; and †Campbell Clinic/University of Tennessee Health Science Center, Memphis, TN.

Purpose: To determine the proximity and potential risks to distal leg anatomy from anterior to posterior (A-P) applied distal tibia locking screws for tibial nailing.

Design: Retrospective.

Setting: ACS level I trauma center. Read More

AJR Am J Roentgenol 2017 Feb;208(2):373-379

1 Department of Radiology, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.116, Houston, TX 77030.

Objective: Tendon injuries are a commonly encountered finding in ankle CT examinations performed for fractures. This study was designed to identify the incidence and associations of tendon injuries in ankle CT examinations performed for fractures.

Materials And Methods: A retrospective review was performed of 410 patients who underwent ankle CT during a 6-year period. Read More

J Am Podiatr Med Assoc 2016 Nov;106(6):449-452

Rupture of the tibialis posterior tendon associated with ankle fracture is rare and difficult to diagnose. This rupture can be easily overlooked because the clinical examination is limited owing to acute pain related to a closed ankle fracture. Complete rupture of the tibialis posterior tendon can be identified by a loss of tension during ankle fracture fixation, but partial rupture is more difficult to detect because the tibialis posterior tendon can maintain its tension. Read More

Medicine (Baltimore) 2016 Dec;95(51):e5346

aDepartment of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul bDepartment of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Seonam University, Goyang cDepartment of Anesthesiology and Pain Medicine, National Police Hospital, Seoul dDepartment of Anesthesiology and Pain Medicine, Institute for Integrative medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary's Hospital, Incheon, Republic of Korea.

Rationale: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Read More

Foot Ankle Spec 2016 Dec 22;9(6):527-533. Epub 2016 Sep 22.

Department of Orthopaedic Surgery (JAK, AB, PKG), University of Massachusetts Medical School, Worcester, Massachusetts.

Open reduction internal fixation of posterior malleolus fractures from a posterior approach is gaining popularity. One concern that has not been studied is the risk of iatrogenic injury to anatomical structures on the anterior ankle. The purpose of this study is to determine the proximity of these anterior structures with relation to K-wires advanced through the anterior cortex. Read More

Foot Ankle Int 2016 Aug;37(8):803-8

Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

Background: Irreparable peroneus brevis tendon tears are uncommon, and there is scant evidence on which to base operative treatment. Options include tendon transfer, segmental resection with tenodesis to the peroneus longus tendon, and allograft reconstruction. However, the relative effectiveness of the latter 2 procedures in restoring peroneus brevis function has not been established. Read More

Orthopedics 2016 Sep 1;39(5):e970-5. Epub 2016 Jun 1.

Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture. Read More

Emerg Radiol 2016 Aug 27;23(4):357-63. Epub 2016 May 27.

Department of Radiology, Louisiana State University Health-Shreveport, Shreveport, LA, USA.

The purpose of this study was to assess the incidence of tendon entrapments and tendon dislocations associated with ankle and hindfoot fractures in patients studied by multidetector computed tomography (MDCT). Additionally, we describe particular tendon injuries associated with specific fractures. This was a retrospective review of all individuals with a trauma-protocol CT for suspected ankle and/or hindfoot fractures during a consecutive 41-month time period at a single Level I Trauma Center. Read More

Rheumatol Int 2016 Jun 19;36(6):863-9. Epub 2016 Mar 19.

Department of Rheumatology, Faculty of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Doctor Esquerdo 46, 28007, Madrid, Spain.

To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/foot fresh-frozen cadaveric specimens. Read More

Am J Orthop (Belle Mead NJ) 2016 Mar-Apr;45(3):E103-7

Department of Orthopedic Surgery, Rhode Island Hospital, Providence, RI.

Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. Read More

J Foot Ankle Surg 2016 May-Jun;55(3):542-6. Epub 2016 Feb 9.

Professor, Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

The present study aimed to diagnose complete rupture (CR) and longitudinal rupture (LR) of the posterior tibial tendon (PTT) from the magnetic resonance imaging findings in patients with PTT dysfunction and to analyze and compare the radiographs from each group to identify radiographic indicators related to the progression of PTT injury that would allow the radiographic diagnosis of CR. We evaluated 32 feet in 27 patients with PTT dysfunction (mean age 66.5, range 49 to 82, years). Read More

BMJ Case Rep 2016 Feb 3;2016. Epub 2016 Feb 3.

ABC Medical Center, Mexico, Mexico.

In this case report, we present an acute rupture in the muscular tendinous junction of a posterior tibialis muscle in a bimalleolar closed ankle fracture after a high-energy trauma in a 30-year-old patient with no significant medical history. Fracture was confirmed by simple X-rays, and was treated with an open reduction in which both of the fractures were treated with osteosynthesis material and reparation of the syndesmosis. If left untreated, this uncommon finding can result in a bad postsurgical outcome; we believe this injury is more common but under-reported in the literature. Read More

AJR Am J Roentgenol 2016 Feb;206(2):366-72

1 Department of Radiology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.

Objective: The purpose of this study was to evaluate the prevalence and common location of a coexisting osteochondral lesion of the distal tibia and fibula and of associated abnormalities of the ankle ligaments and tendons on MRI in patients with an osteochondral lesion of the talus (OLT).

Materials And Methods: A search of a database of MRI studies performed between July 2003 and January 2014 yielded MRI examinations of 297 feet with OLTs. Two readers reviewed the MRI examinations independently for the presence of an osteochondral lesion of the distal tibia and fibula and for concomitant ligament and tendon injuries. Read More

J Appl Biomech 2016 Apr 21;32(2):160-70. Epub 2015 Oct 21.

Department of Surgery and Cancer and the Department of Bioengineering, Imperial College London, London, U.K.

Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges works remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. Read More

J R Army Med Corps 2016 Oct 13;162(5):393-395. Epub 2015 Oct 13.

Brighton & Sussex University Hospitals, Brighton, East Sussex, UK.

Tibialis posterior tendon injuries are commonly missed and can result in significant foot deformity. In the young athlete these are best diagnosed acutely with ultrasound and may be treated conservatively or operatively. We present the case of a young serviceman and describe the treatment plan that was successful in allowing an early return to exercise. Read More

Foot Ankle Spec 2016 Aug 7;9(4):361-6. Epub 2015 Oct 7.

Department of Orthopedic Surgery, University of South Alabama, Mobile, Alabama (JM)Andrews Research and Education Institute, Foot and Ankle Center, Gulf Breeze, Florida (WW, EN, CK).

Unlabelled: Dislocation of the posterior tibial tendon (PTT) is a rare pathological process that occurs most often as a result of acute trauma. The injury involves forced dorsiflexion and eversion of the foot against a contracted posterior tibialis. Diagnosis of the injury is often difficult secondary to the rarity of the injury and its similarity with other benign injuries of the medial ankle. Read More

J Foot Ankle Surg 2015 Nov-Dec;54(6):1124-6. Epub 2015 Aug 5.

Orthopedics Department, Meir Medical Center, Kfar-Saba, Israel, associated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Acquired flatfoot deformity in adults is usually due to partial or complete tearing of the posterior tibial tendon, with secondary failure of other structures such as the plantar calcaneonavicular (spring) ligament (SL), which maintain the medial longitudinal arch. In flexible cases, the tibialis posterior can be replaced with the flexor digitorum longus. It is common practice to suture the SL directly in the case of a tear; however, if the tear is complete, suturing directly to the ligament alone will not be possible. Read More

J Foot Ankle Surg 2016 May-Jun;55(3):633-7. Epub 2015 Jul 26.

Emeritus Professor, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.

Extensive damage of the tibialis anterior tendon is rare and mainly caused by trauma. Surgical treatment of these injuries can become challenging owing to the limited availability of autogenous graft resources for reconstruction of the defect. In the present case report, we describe a large defect in the midfoot soft tissue after a traffic injury, which included complete loss of the tibialis anterior tendon. Read More

Foot Ankle Spec 2016 Jun 25;9(3):275-8. Epub 2015 Jun 25.

Department of Orthopaedics, Brigham and Women's Hospital, Boston, Massachusetts

Background: Posterior tibial tendon dysfunction is a common cause of adult acquired flatfoot deformity. The cause of posterior tibial tendon dysfunction is often multifactorial and may include repetitive microtrauma, poor blood supply to the tendon, and, rarely, traumatic rupture.

Case Description: We present the case of a 69-year-old male with posterior tibial tendon dysfunction secondary to a stingray injury that occurred directly into the posterior tibial tendon. Read More

Zhonghua Yi Xue Za Zhi 2015 May;95(17):1290-4

Department of Medical Imaging, Third Affiliated Hospital, Southern Medical University, the Institute of Medical Imaging of Bone and Joints, Academy of Orthopedics Guangdong Province, Guangzhou 510630, China.

Objective: To analyze the imaging abnormal findings of ankle injuries in professional soccer player of males.

Methods: The thirty-two professional soccer players in local region soccer club had been selected as research objects from March 2014 to January 2015, and all were men. Average age was 22. Read More

J Foot Ankle Surg 2016 Jul-Aug;55(4):832-7. Epub 2015 May 12.

Ortopaedic and Traumatology Unit, IRCCS S. Martino IST, Genoa, Italy.

Ankle fractures represent an exciting field of traumatology because of the wide variety of clinical presentations, injury mechanisms, and treatment options. Rupture of the posterior tibialis tendon (PTT) with ankle fracture can occur during trauma that involves pronation and external rotation of the foot or, less commonly, secondary to direct trauma to the ankle. This tendon injury is uncommon and probably misdiagnosed in many cases, because of the difficult clinical examination secondary to the pain and swelling. Read More

Foot Ankle Spec 2015 Oct 24;8(5):364-8. Epub 2015 Apr 24.

Department of Orthopedics, Rowan University School of Osteopathic Medicine, Stratford, New Jersey (CWR)The Rothman Institute, Egg Harbor Township, New Jersey (FAS)Rothman Institute at Jefferson Medical College, Philadelphia, Pennsylvania (HNK, JND)

Unlabelled: The link between increased body weight and hindfoot complaints is largely based on correlation to single foot pathology. We retrospectively reviewed 6879 patients with tibialis posterior tendonitis (TPT), plantar fasciitis (PF), or both. Among patients with either TPT or PF, 1 in 11 (9%) had both. Read More

Foot Ankle Int 2015 Jul 10;36(7):812-9. Epub 2015 Mar 10.

Hospital for Special Surgery, New York, NY, USA

Background: The purpose of the current study was to report functional outcomes of tendoscopy for treatment of tibialis posterior tendon pathology as well as compare its diagnostic capability with magnetic resonance imaging (MRI).

Methods: Clinical records and MRI of 12 patients who underwent tendoscopy of the tibialis posterior tendon (TPT) were retrospectively reviewed. Mean follow-up was 31 months (range, 26-43 months). Read More

J Foot Ankle Surg 2016 Mar-Apr;55(2):348-50. Epub 2015 Jan 30.

Consultant Orthopaedic Surgeon, Trauma and Orthopaedics Department, Queen's Hospital, Romford, Essex, United Kingdom.

We present the case of a 14-year-old female who presented with unilateral pes planus 30 months after a bimalleolar ankle fracture dislocation. At surgery, the tibialis posterior tendon was encased in fracture callus within the syndesmosis and required reconstruction using flexor digitorum longus transfer. Dislocation of the tibialis posterior tendon and entrapment within the tibiofibular syndesmosis has been previously reported. Read More

J Foot Ankle Surg 2015 Mar-Apr;54(2):268-72. Epub 2015 Jan 21.

Associate Professor, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL. Electronic address:

Irreducible ankle fracture-dislocations are rare. Several cases of irreducible ankle fracture-dislocation have been reported in published studies secondary to the tibialis posterior tendon, deltoid ligament, or extensor digitorum longus tendon blocking the reduction. We report a case of irreducible ankle fracture-dislocation resulting from posteromedial subluxation of the tibialis anterior tendon around a medial malleolar fracture fragment. Read More