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the tendon forms in the lower third of the leg and passes within a thick retinaculum in a groove over the posterior and inferior margin of the medial malleolus. The Tibialis Posterior muscle originates from the posterior border of the Tibia, the Interosseous Membrane and the fibula. Failure of either the ligamentous restraints, the joints or the muscle motors lead to dysfunction of the foot, often in association with pain. The Tibialis Posterior tendon is the primary muscle motor, acting to invert the hindfoot converting its function to allow the calf muscles to generate force through the foot more efficiently, and to prevent excessive eversion. There are multiple interlinked static restraints of the hindfoot including the Deltoid ligament, Plantar Fascia, Spring Ligament, Interosseous Ligaments, cervical ligament, the inferior extensor retinaculum.ĭynamic stabilisers include the Tibialis Posterior, Tibialis Anterior, the Achilles, Peroneals, Intrinsic foot muscles and to a lesser degree the long to flexors.
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Normal hindfoot mechanics are reliant upon static (ligamentous), dynamic (musculo-tendinous) restraints, it’s function will also be affected by proximal (e.g valgus knee) and distal (e.g. Movement of the hindfoot from eversion to inversion, alters the alignment of the chopart articulation and converts the flexible foot, useful for balance and shock absorption, into a closed pack, rigid configuration, which allows the foot to function as a mechanically effective lever. Stability, flexibility and motor control of the hindfoot are very important components of the normally functioning foot. Reports of flat foot deformity in association with tibialis posterior pathology appeared in the literature in the 1960’s, in 1989 Johnson and Strom developed a classification for Tibialis Posterior dysfunction, based on the progression of deformity and its treatment. Our e-learning platform contains high resolution images and a certified CME of the Pes Planus correction with FDL transfer, Calcaneal osteotomy and Wright Bioarch arthroresis screw surgical procedure. Learn the Pes Planus correction with FDL transfer, Calcaneal osteotomy and Wright Bioarch arthroresis screw surgical technique with step by step instructions on OrthOracle.
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