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Tibialis Posterior Tendon Dysfunction

Aetiology

  • Increased in middle aged obese women
    • Diabetes
    • Hypertension
    • Obesity
    • Prior surgery or trauma about medial foot
    • Steroid treatment
    • ± trauma
    • pre-exitising flatfoot
  • Most ruptures due to Intrinsic abnormality
    • Acute angulation around the medial malleolus
    • Hypovascular zone 1-1.5 cm distal to the medial malleolus & extending 1cm further distally- Frey 1990
    • Linked to seronegative disorders
      • Ankylosing Spondylitis
      • Reiters
      • Psoariasis
    • Recent evidence to suggest that flatfoot deformity in RA more related to synovitis of Talonavicular & Subtalar joints