tibialis posterior dysfunction

Management

Surgical Algorithm

 

Stage 1 Tendonitis

 

Non-operative

 

Walking cast / NSAIDS

- 6/52

 

UCBL

- 3/12

- worn inside the shoe

- ends under malleoli

- controls the heel (which must be flexible)

- supports the arch

 

Operative / Synovectomy and debridement

(+/- FDL transfer and calcaneal osteotomy +/- T Achilles lengthening)

Background

Aetiology

 

Intrinsic

- inflammatory

- degenerative

 

Extrinsic

- traumatic

- spur

 

Epidemiology

 

F > 40

 

Associations 60% of cases  

- hypertension

- diabetes

- obese

- trauma 

- prior surgery

- steroids