The tibialis posterior tendon divides into multiple slips at the navicular tuberosity — the primary attachment — with medial slips to the medial cuneiform and plantar surfaces. The medial primary slip is the most critical component for medial arch support and hindfoot valgus prevention.
Tibialis posterior tendon dysfunction (PTTD) begins with degeneration of the medial slip at the navicular attachment, producing progressive flatfoot deformity. Stage I PTTD has an intact but painful tendon; Stage II has an attenuated tendon with flexible flatfoot; Stage III-IV progress to fixed deformity. The medial slip quality determines whether direct repair is feasible or tendon transfer (FDL to navicular) is required.
Progressive medial slip tendon degeneration producing flexible acquired flatfoot with the characteristic too-many-toes sign and single heel rise failure, managed by FDL tendon transfer and medialising calcaneal osteotomy.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
