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If physical therapy fails, patients will often be referred for surgery. [1] [2] Surgery procedures become more invasive as the condition progresses. Tenosynovectomy with tubularization; Medial calcaneal osteotomy with posterior tendon debridement and repair; Flexor digitorum tendon (FDL) transfer; Spring ligament reconstruction; Achilles tendon ...
[1] [2] [3] When it is symptomatic, surgery may be necessary. Accessory navicular bone may cause a continuous stretch and stress on the tibialis posterior tendon which can progress to chronic disabling pain and may cause tendon rupture or secondary flat foot deformity; when this occurs this condition is commonly known as accessory navicular ...
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 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]
Surgery can be open (via an incision) or closed (via arthroscopy). [3] In cases of flatfoot, sinus tarsi syndrome is complicated by the collapse of the arches. In these cases, surgery includes debridement (cleaning out) of the sinus tarsi and possible reconstruction of the foot. Surgery can also include debridement of bone spurs as well. [4]
Tendon transfer surgery is necessary when a certain muscle function is lost because of a nerve injury. If a nerve is injured and cannot be repaired, then the nerve no longer sends signals to certain muscles. Those muscles are paralyzed and their muscle function is lost. Tendon transfer surgery can be used to attempt to replace that function.
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 popliteus tendon's main attachment is on the femur at the proximal portion of the popliteus sulcus. As the tendon runs posteriorly and distally behind the knee, it gives off 3 fascicles that attach to and stabilize the lateral meniscus. The popliteus tendon provides static and dynamic stabilization to the knee during posterolateral rotation.