Hindfoot motion following reconstruction for posterior tibial tendon dysfunction.
BACKGROUND
Due to advances in technology, segmental gait analysis of the foot is now possible and can elucidate hindfoot deformity in persons with posterior tibial tendon dysfunction (PTTD). This study evaluated the motion of the hindfoot and ankle power following surgical reconstruction for PTTD utilizing a segmental foot model during gait.


METHODS
Twenty patients who underwent posterior tibial tendon reconstruction for Stage 2 PTTD using transfer of the flexor digitorum longus tendon to the navicular tuberosity, reconstruction of the calcaneo-navicular ligament complex, and a medial displacement calcaneal osteotomy were evaluated at a minimum followup of 1 year. Three-dimensional gait analysis was performed utilizing a 4-segment foot model. Temporal-spatial parameters included walking velocity, cadence, step length, and single support time. Sagittal, coronal, and transverse hindfoot motion with respect to the tibia/fibula and ankle power was calculated throughout the gait cycle.


RESULTS
Walking velocity, cadence, and step length were not significantly different between the study subjects and the normal control group. Study patients did show a significantly smaller single support time on both the affected and unaffected limbs compared to controls. There was no statistical difference in plantarflexion-dorsiflexion, varus-valgus, or ankle push-off power between the affected and unaffected sides of the study subjects, or between the affected side and the controls.


CONCLUSIONS
In this preliminary postoperative study, surgical reconstruction for PTTD effects quantifiable objective improvement in walking velocity, hindfoot motion and power.
Brodsky
James W
JW
Baylor University Medical Center, Department of Orthopaedic Surgery, 411 North Washington Avenue, Suite 7000, Dallas, TX 75246, USA. jbrodsky@dallasortho.com
Charlick
Daniel A
DA
Coleman
Scott C
SC
Pollo
Fabian E
FE
Royer
Christian T
CT
D000328:Adult; D000368:Aged; D049628:Body Size; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006365:Heel; D006801:Humans; D008297:Male; D008875:Middle Aged; D037081:Posterior Tibial Tendon Dysfunction / Q000503:physiopathology* / Q000601:surgery*; D020127:Recovery of Function; D013640:Tarsal Joints / Q000503:physiopathology*; D016896:Treatment Outcome