Posterior Tibial Tendon Insufficiency (PTTI) Pathway
Posted: 6/15/2020
ID: (C101502)
Naval Medical Center Portsmouth
Acquired Pes Planovalgus in 47M
PRESENTATION
4
POLLS
6,155
OUTCOMES
7
VIDEOS
3
EVIDENCE
22
Comments
21
CASE DESCRIPTION
AGE | 47 / Male |
CC | Left foot pain |
HPI | A 47 year-old male presents with chronic left foot pain and a flatfoot deformity. He attempted shoewear modifications, physical therapy, and custom orthotics (including medial posting with medial arch support) for an extended period of time. Despite this symptoms remain severe. |
PMH | Unremarkable |
PE | On physical exam on the left foot there is a pes planovalgus with "too many toes" sign. He is unable to perform a single leg heel rise on the affected side. The deformity is passively correctable. He otherwise has good strength. His neurovascular exam is normal. |
Pre-procedure IMAGES:




POLLS
OB Community
CASE OUTCOMES
PROCEDURE 1:
Mediallizing calcaneal osteotomy, 1st metatarsal dorsal opening wedge osteotomy, temporary pinning of reduced talonavicular joint, spring ligament repair, posterior tibialis tendon advancement (in lieu of FDL transfer)
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Intra-procedure P1
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Post-procedure P1
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EVIDENCE (22)