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My Ankle…Posterior Tibial Tendon Insufficiency

My Ankle…Posterior Tibial Tendon Insufficiency. Posterior Tibial Tendon (PTT). B ig tendon Location: Inside part of ankle Function: Turn foot in Maintain the arch. Typical Presentation. Gradual onset Arch collapses Foot becomes very flat. Over Time…. “Foot roles inward”

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My Ankle…Posterior Tibial Tendon Insufficiency

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  1. My Ankle…Posterior Tibial Tendon Insufficiency

  2. Posterior Tibial Tendon (PTT) • Big tendon • Location: Inside part of ankle • Function: • Turn foot in • Maintain the arch

  3. Typical Presentation • Gradual onset • Arch collapses • Foot becomes very flat

  4. Over Time…. • “Foot roles inward” • Progressive pain/deformity

  5. PTT Tendinopathy : Symptoms • Arch pain/swelling • Arch collapses • Acquired flat foot

  6. Symptoms • Decreased strength • Cannot rise on one foot

  7. Who is at risk? • Usually middle-aged and older individuals • Females > males • Often sedentary

  8. Other Risk Factors • Excessive body weight • Preexisting flat feet • Diabetes

  9. Stages ( Severity of Condition) • Stage I-Early • no deformity • Stage II-Moderate • painful, flexible flat foot • Stage III-Advanced • Stiff/painful flat foot

  10. Progression Over Time

  11. Traditional Nonoperative Treatment • Anti-inflammatory medication • Orthotics • Braces • Immobilization • Physical therapy • Modalities • Strengthening

  12. Surgical Options • Many • Depends on stage • Options • Tendon debridement • Tendon transfers • Bone realignments • Bone Fusions • Combinations of above

  13. Heel Bone Realignment and Tendon Transfer • Popular surgical option • Usually….. • Corrects deformity • Reduces pain • Improves strength

  14. Prognosis • Nonoperative treatment-fair • Surgical treatment-mostly good/excellent • But…. • Requires immobilization • Protected weight bearing • Lengthy recovery

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