Plantar flexion of the ankle and initiation of inversion of the hindfoot at the Finally, a posterior division inserts onto sustentaculum tali anteriorly (Figure 1). A second division attaches the plantar surfaces of the middle and lateral cuneiforms, as well as the cuboid and the bases of the second to fifth metatarsals. The anterior division of the tendon inserts onto the navicular tuberosity, the medial naviculo-cuneiform joint capsule and the inferior surface of the medial cuneiform. It passes distally, anterior to the tuberosity of the navicular, where it divides. The posterior tibial tendon then runs at an acute angle behind the medial malleolus in a fibro-osseous groove, encased in a teno-synovial sheath. It is located in the deep posterior compartment of the lower leg and is innervated by the posterior tibial nerve (Figure 1). The posterior tibial muscle takes its origin from the posterior aspect of the proximal tibia, fibula and interosseous membrane.
The development of adult acquired flat foot, the most common of these is theĭysfunction of the posterior tibial tendon. There are several factors associated with Important in order to initiate appropriate management. Early recognition and diagnosis is therefore
However, symptomatic patients can have severe pain and instability It is occasionally an asymptomatic incidental finding on clinicalĮxamination. It can be defined as partial orĬomplete loss or collapse of the medial longitudinal arch.Īdult acquired flat foot can have a varied Literature looking at this relatively common deformityĪcquired flat foot is a relatively commonĭeformity encountered in the adult population.
Killen, Rajiv Limaye and Neil Limaye conduct a brief review of the
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