Surgical treatment of the posterior tibial tendon dysfunction stage II through transfer of the digitorum longus flexor and medial calcaneal osteotomy

Abstract

Objective: To evaluate clinical and functional effectiveness of the transfer of the FDL and medial osteotomy of calcaneus in the management of stage ll posterior tibial tendon dysfunction. Methods: Became a retrospective evaluation of patients treated at the foot and ankle unit in San Juan Bosco clinic between 2012 and 2014. Sixteen patients were evaluated, of which two had a stage lll of the pathology for which were dropped from the study, fourteen of them realized them transfer of the FDL by tenodesis at the distal stump of the posterior tibial tendon and medial osteotomy of calcaneus, three patients needed additional procedure of Cotton and other four showed a spring ligament injury, by what was repaired. Assessed pre and post-surgery the pain, the alignment of the foot, hind foot inversion and plantar flexion and is quantified by the AOFAS. The average follow-up time was 1-year. Results: The AOFAS score improved on average of 44 to 82.5, a patient lost the function of the tendon, in two patients the pain continues but in lesser frequency and intensity. Conclusion: Our study can conclude that the FDL transfer and medial calcaneal osteotomy is an excellent therapeutic option for the management of the posterior tibial dysfunction Stage ll because it restores the function and correct alignment.