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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 1999 September;23(3):107-12
Surgical treatment of adult acquired flat foot caused by posterior tibialis tendon dysfunction
Bardelli M., Conti S. A., De Simone L., Teti A.
The surgical treatment of adult acquired flat foot deformity caused by posterior tibialis tendon dysfunction depends on the importance of symptoms and stage of disease. A three-stage classification of posterior tibialis tendon dysfunctionhis used, as proposed by Johnson and Strom in 1989 and modified by Myerson in l996 including a fourth stage. This classification is very useful also as guideline for operative treatment. Fourty cases (27 to 64 years) have been operated in the Orthopaedic Department of Montevarchi Hospital (Arezzo - Tuscany); 21 cases had been classified as second stage and 19 as third stage. In the second stage, a talo-calcaneal arthrorisis was performed by Giannini's device and medial retaining of posterior tibialis tendon pro anterior tibialis tendon. In the third stage, double arthrodesis was performed: talo-calcaneal arthrodesis with lateral approach and talo-navicular arthrodesis with medial approach and stabilization by two staples. The clinical and radiographic results of follow-up evaluation (1 to 7 years) of 39 cases are reported, using the criteria, partially modified, proposed by Angus and Cowell in 1986. The results obtained in the cases at the second stage (14 good, 5 fair, 1 poor) were better than in the cases at the third stage (10 good, 7 fair, 2 poor).