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Flexor Digitorum Longus to Posterior Tibialis Transfer With Lateral Column Lengthening for Stage II Posterior Tibial Tendon Dysfunction

Flemister, A. Samuel Jr MD; Baumhauer, Judith F. MD; Digiovanni, Benedict F. MD

Techniques in Foot & Ankle Surgery: March 2007 - Volume 6 - Issue 1 - p 22-29
doi: 10.1097/BTF.0b013e318031f943

Acquired adult flatfoot deformity secondary to posterior tibial tendon dysfunction is characterized by pathological increases in forefoot abduction and hindfoot valgus. This deformity leads to a relative shortening of the lateral column of the foot with respect to the medial column. Lateral column lengthening procedures using either an anterior calcaneal osteotomy or calcaneocuboid distraction arthrodesis have the ability to restore the radiographic parameters of the medial longitudinal arch. These lateral column lengthening procedures when combined with medial stabilizing procedures and lengthening of the gastrocsoleus complex are clinically useful in decreasing pain and improving function in patients with stage II posterior tibial tendon dysfunction. However, these procedures are technically demanding, complications are common, and long recovery periods are the norm.

Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY

Address correspondence and reprint requests to A. Samuel Flemister Jr, MD, Box 665, 601 Elmwood Ave, Rochester, NY 14642. E-mail:

None of the authors have received any support related to this material.

© 2007 Lippincott Williams & Wilkins, Inc.