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Posterior tibial tendon dysfunction is the dysfunction of the posterior tibial tendon. It is a progressive disease that has four stages [ 1 ] and is the most common cause of adult flatfoot . [ 2 ]
The tibialis posterior muscle originates on the inner posterior border of the fibula laterally. [2] It is also attached to the interosseous membrane medially, which attaches to the tibia and fibula. [2] The tendon of the tibialis posterior muscle (sometimes called the posterior tibial tendon) descends posterior to the medial malleolus. [2]
Pimenta's point is an anatomical landmark for easy location of the posterior tibial artery or tibialis posterior artery (a peripheral pulse on the inside of the ankle). An imagined line is drawn between the bony prominence of the medial malleolus and the insertion of the achilles tendon.
Posterior surface of calcaneus via calcaneal tendon: Tibial nerve (S1, S2) Plantarflexes ankle when knee is extended; raises heel during walking; flexes leg at knee joint Plantaris: Inferior end of lateral supracondylar line of femur; oblique popliteal ligament: Weakly assists gastrocnemius in plantarflexing ankle Soleus
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]
If non-invasive treatment measures fail, tarsal tunnel release surgery may be recommended. Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle.
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
The patella plays no significant role in the posterolateral corner. The bony shape of the posterolateral knee, with the two convex opposing surfaces of the lateral femoral condyle and the lateral tibial plateau, makes this portion of the knee inherently unstable compared to the medial aspect. Thus, it has a much higher risk of not healing ...