A condition known as Posterior Tibial Tendon Dysfunction is commonly seen in women usually over the age of 50. Ankle / Foot tibial dysfunction condition has association with several risk factors, namely: female sex, high blood pressure, obesity, diabetes, and age. The actual physical changes of foot tibial dysfunction involve the degeneration and tearing of the Posterior Tibial Tendon as it courses along the lower end of the leg at the ankle joint medially.
The patient typically complains of persistent pain and swelling on the inside of the ankle. In the early stages there are no abnormalities of foot shape. The pain is usually activity related and often is worse first thing in the morning upon arising.
The diagnosis of posterior tibial tendon dysfunction is usually made clinically with no abnormality on plain x-rays. MRI or Ultrasound testing can confirm the findings.
Activity modification, rest and protection are helpful in the early stages of ankle/foot tibial dysfunction. This can usually be accomplished with an orthotic insert into the shoe or a removable boot walker. Care should be taken to avoid excessive weight bearing or walking long distances during acute flare- ups of this condition.
In the event of worsening conditions, such as the palpation of navicular medial head of talus, surgery may be necessary to prevent arch collapse.
A more commonly performed procedure for posterior tibial tendon dysfunction is a tendon transfer and heel shift. The surgery is moderately complex and involved as well as tenuous in the early healing phases. In this event, prolonged immobilization and protection are required to avoid improper healing and failure of the surgery. The patient may have to remain non weightbearing in a cast for approximately 6 weeks and then light weight bearing for an additional 4-6 weeks, continuing in the cast.
Due to the nature and extent of foot tibial dysfunction surgery, the patient may expect to experience swelling for six months and the surgery is effective 85% of the time.
For more information on how the posterior tibial tendon dysfunction specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!
Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC.