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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 1999 September;23(3):107-12

language: Italian

Surgical treatment of adult acquired flat foot caused by posterior tibialis tendon dysfunction

Bardelli M., Conti S. A., De Simone L., Teti A.


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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).

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