Adult-acquired flatfoot or posterior tibial tendon dysfunction tends to lead to a gradual loss of the arch. The posterior tibial muscle is a deep muscle in the back of the calf. It is a long tendon that extends from above the ankle and attaches into several sites around the arch of the foot. This muscle acts like a stirrup on the inside of the foot supporting the arch. The posterior tibial muscle stabilizes the arch and creates a rigid platform for walking and running. If this muscle and/or tendon is damaged or torn, the arch loses its stability and collapses, resulting to a flatfoot.
Podiatrists recommend surgery to give patients a stable and functional foot. Depending on the severity of the deformity, this corrective surgery will require several procedures. These may include:
- Tenosynovectomy – a procedure to clean away (debridement) and remove any of the inflamed tissue around the tendon.
- Osteotomy – removal of a portion of the heel bone (calcaneus) to move the foot structure back into alignment.
- Tendon Transfer – in which replacement fibers from another tendon are inserted to help repair damage.
- Lateral Column Lengthening – implants a small piece of bone (usually from the hip) outside the heel bone to create the proper bone alignment and rebuild the arch.
- Arthrodesis – fusing one or more bones together to eliminate any joint movement, which stabilizes the foot and prevents any further deterioration or damage.