title: Flexor digitorum longus transfer and medial displacement calcaneal osteotomy for the treatment of stage II posterior tibial tendon dysfunction: kinematic and functional results of fifty one feet.
abstract: OBJECTIVE
  Stage II posterior tibial tendon dysfunction (PTTD) can be treated by flexor digitorum longus (FDL) tendon transfer and medial displacement calcaneal osteotomy (MDCO). Numerous authors have studied the clinical and radiographic results of this procedure. However, little is known about the kinematic changes. Therefore, the purpose of this study was to assess plantar-pressure distribution in these patients.
  
  
  METHODS
  Seventy-three patients with PTTD stage II underwent FDL tendon transfer and MDCO. Plantar pressure distribution and American Orthopaedic Foot and Ankle Society (AOFAS) score were assessed 48 months after surgery. Pedobarographic parameters included lateral and medial force index of the gait line, peak pressure (PP), maximum force (MF), contact area (CA), contact time (CT) and force-time integral (FTI).
  
  
  RESULTS
  In the lesser-toe region, PP, MF, CT, FTI and CA were reduced and MF in the forefoot region was increased. These changes were statistically significant. We found statistically significant correlations between AOFAS score and loading parameters of the medial midfoot.
  
  
  CONCLUSIONS
  Study results reveal that FDL tendon transfer and MDCO leads to impaired function of the lesser toes during the stance phase. However, there seems to be a compensating increased load in the forefoot region.
authors: Department of Orthopaedics, Medical University of Vienna, Austria. reinhard.schuh@meduniwien.ac.at
authors: Reinhard
authors: R
authors: Schuh
authors: Florian
authors: F
authors: Gruber
authors: Axel
authors: A
authors: Wanivenhaus
authors: Nikolaus
authors: N
authors: Hartig
authors: Reinhard
authors: R
authors: Windhager
authors: Hans-Joerg
authors: HJ
authors: Trnka
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002111:Calcaneus / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D037081:Posterior Tibial Tendon Dysfunction / Q000503:physiopathology* / Q000601:surgery*; D011312:Pressure; D013709:Tendon Transfer
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