Skip to main content

Flatfoot Surgery

  • Chapter
  • First Online:
Complications in Foot and Ankle Surgery
  • 1675 Accesses

Abstract

Posterior tibial tendon dysfunction (PTTD) is a complex multiplanar deformity that represents a technically challenging treatment plan for the foot and ankle surgeon. While there have been numerous procedures described for the treatment of PTTD, an algorithmic classification system has been designed to help aid the foot and ankle surgeon in selective procedures. While this classification system aids in the selection of procedures there is no algorithmic approach for the management of complications associated with surgical correction of the symptomatic flatfoot. This chapter, while not all inclusive for all flatfoot surgical procedures, will outline the biomechanics of a symptomatic flatfoot, highlight an algorithmic approach to procedure selection, and focus on management strategies for complications associated with the most common procedures performed for the treatment of Adult flatfoot/PTTD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Weinraub GM, Saraiya MJ. Adult flatfoot/posterior tibial tendon dysfunction: classification and treatment. Clin Podiatr Med Surg. 2002;19(3):345–70.

    Article  PubMed  Google Scholar 

  2. Weinraub GM, Heilala MA. Adult flatfoot/posterior tibial tendon dysfunction: outcomes analysis of surgical treatment utilizing an algorithmic approach. J Foot Ankle Surg. 2000;39(6):359–64.

    Google Scholar 

  3. Root ML, Orien WP, Weed JH. Normal and abnormal function of the foot: Clinical Biomechanics.

    Google Scholar 

  4. Myerson MS. Adult acquired flatfoot deformity: treatment of dysfunction of the posterior tibial tendon. J Bone Joint Surg. 1996;78-A(5):780–92.

    Article  Google Scholar 

  5. Conti S, Michelson J, Jahss MD. Rupture of the posterior tibial tendon. J Bone Joint Surg. 1990;72A:884–8.

    Google Scholar 

  6. Hill RS. Ankle Equinus: prevalence and linkage to common foot pathology. J Am Podiatr Med Assoc. 1995;85:295–300.

    Article  CAS  PubMed  Google Scholar 

  7. Thordarson DB, Schmotzer H, Chon J, et al. Dynamic support of the human longitudinal arch. A biomechanical evaluation. Clin Orthop Relat Res. 1995;316:165–72.

    Google Scholar 

  8. Astion DJ, Deland JT, Otis JC, et al. Motion of the hindfoot after simulated arthrodesis. J Bone Joint Surg. 1997;79-A(2):241–6.

    Article  Google Scholar 

  9. Weinraub GM, Schuberth JM, Lee M, Rush S, Ford L, Neufeld J. Isolated medial incisional approach to subtalar and talonavicular arthrodesis. J Foot Ankle Surg. 2010;49:326–30.

    Article  PubMed  Google Scholar 

  10. Mosier-LaClair S, Pomeroy G, Manoli A. Operative treatment of the difficult stage 2 adult acquired flatfoot deformity. Foot Ankle Clin. 2001;6:95–119.

    Article  CAS  PubMed  Google Scholar 

  11. Toolan BC, Sangeorzan BJ, Hansen ST. Complex reconstruction for the treatment of dorsolateral peritalar subluxation of the foot. JBJS. 1999;81-A:1545–60.

    Article  Google Scholar 

  12. Chi TD, Toolan BC, Sangeorzan BJ, Hansen ST. The lateral column lengthening and medial column stabiliztion procedures. CORR. 1999;365:81–90.

    Article  Google Scholar 

  13. Conti SF, Wong TS. Osteolysis of structural autograft after calcaneocuboid distraction arthrodesis for stage II posterior tibial tendon dysfunction. Foot Ankle Int. 2002;23:521–9.

    Article  PubMed  Google Scholar 

  14. Hinterman B, Valderrabano V, Kundert HP. Lengthening of the lateral column and reconstruction of the medial soft tissue for treatment of acquired flatfoot deformity associated with insufficiency of the posterior tibial tendon. Foot Ankle Int. 1999;20:622–9.

    Article  Google Scholar 

  15. Grier GM, Waling AK. The use of tricortical autograft vs allograft in lateral column lengthening for adult acquired flatfoot deformity: an analysis of union rates and complications. Foot Ankle Int. 2010;31:760–9.

    Article  PubMed  Google Scholar 

  16. Budny AM, Grossman JP. Naviculocuneiform arthrodesis. Clin Podiatr Med Surg. 2007;24:753–63.

    Article  PubMed  Google Scholar 

  17. Rockett AK, Magnum G, Mendicino SS. Bilateral intraosseous cystic formation in the talus: a complication of subtalar arthroereisis. J Foot Ankle Surg. 1998;37(5):421–5.

    Article  CAS  PubMed  Google Scholar 

  18. Harper MC. Deltoid ligament: an antatomical evaluation of function. Foot Ankle. 1987;8:19–22.

    Article  CAS  PubMed  Google Scholar 

  19. Bohay DR, Anderson JG. Stage IV posterior tibial tendon insufficiency: the tilted ankle. Foot Ankle Clin. 2003;8:619–36.

    Article  PubMed  Google Scholar 

  20. Resnick RB, Jahss MH, Choueka J, et al. Deltoid ligament forces after tibialis posterior tendon rupture: effects of triple arthrodesis an calcaneal displacement osteotomies. Foot Ankle Int. 1995;16:14–20.

    Article  CAS  PubMed  Google Scholar 

  21. Barrett GR, Meyer LC, Bray III EW, et al. Pantalar arthrodesis: a long-term follow-up. Foot Ankle. 1981;1:279–83.

    Article  CAS  PubMed  Google Scholar 

  22. Chou LB, Mann RA, Yaszay B, et al. Tibiotalocalcaneal arthrodesis. Foot Ankle Int. 2000;21:804–8.

    Article  CAS  PubMed  Google Scholar 

  23. Lewis J, Adams S, Queen R, et al. Outcomes after total ankle replacement in association with ipsilateral hindfoot arthrodesis. Foot Ankle Int. 2014;35(6):535–42.

    Article  PubMed  Google Scholar 

  24. Johnson KA, Strom DE. Tibialis posterior tendon insufficiency: diagnosis and treatment. Clin Orthop. 1989;239:197–206.

    Google Scholar 

  25. Frey C, Shereff M, Greenidge N. Vascularity of the posterior tibial tendon. J Bone Joint Surg Am. 1990;72:884–8.

    Article  CAS  PubMed  Google Scholar 

  26. Rush SM. Reconstructive options for failed flatfoot surgery. Clin Podiatr Med Surg. 2007;24:779–88.

    Article  PubMed  Google Scholar 

Download references

Summary

PTTD is a complex multiplanar pathology with multiple options for surgical reconstruction. Due to the varying number of surgical procedures and approaches for addressing the deformities associated with PTTD the surgeon must be prepared to encounter complications associated with surgical reconstruction.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Glenn Weinraub .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Weinraub, G. (2017). Flatfoot Surgery. In: Lee, M., Grossman, J. (eds) Complications in Foot and Ankle Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-53686-6_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-53686-6_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-53684-2

  • Online ISBN: 978-3-319-53686-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics