Tibialis posterior rupture: Difference between revisions
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Posterior tibialis tendon ruptures occur predominantly in the late middle-aged population (average age 57 years). For posterior tibialis dysfunction, the patient is typically a female over the age of 40 who exhibits ligamentous laxity in multiple joints and has an occupation that requires extended periods of standing. They usually do not recall any acute traumatic event. There is another subset of the populations in which posterior tibial tendon insufficiency occurs and that consists of the 20- to 40-year old athletes. They usually recall a traumatic event, usually a direct blow to the medial malleolus. Or, they present with years of involvement in athletics with a pronated foot.<ref name="3">William M. Geideman, J. E. Posterior Tibial Tendon Dysfunction. Journal of Orthopedic & Sports Physical Therapy , 2000, (2A SR): 68-77</ref> <br> | Posterior tibialis tendon ruptures occur predominantly in the late middle-aged population (average age 57 years). For posterior tibialis dysfunction, the patient is typically a female over the age of 40 who exhibits ligamentous laxity in multiple joints and has an occupation that requires extended periods of standing. They usually do not recall any acute traumatic event. There is another subset of the populations in which posterior tibial tendon insufficiency occurs and that consists of the 20- to 40-year old athletes. They usually recall a traumatic event, usually a direct blow to the medial malleolus. Or, they present with years of involvement in athletics with a pronated foot.<ref name="3">William M. Geideman, J. E. Posterior Tibial Tendon Dysfunction. Journal of Orthopedic & Sports Physical Therapy , 2000, (2A SR): 68-77</ref> <br> | ||
== Characteristics/Clinical Presentation<ref name=" | == Characteristics/Clinical Presentation<ref name="William M. Geideman" /> == | ||
• Swelling along the medial aspect of the foot and ankle<br>• Absence of the classical sudden severe pain of a tendon rupture<br>• Tenderness along the posterior tibialis tendon<br>• Progressive loss of longitudinal arch → pes planus and heel valgus<br>• Palpable pain between medial malleolus and navicular<br>• Pain in the plantar medial arch <br>[[Image: | • Swelling along the medial aspect of the foot and ankle<br>• Absence of the classical sudden severe pain of a tendon rupture<br>• Tenderness along the posterior tibialis tendon<br>• Progressive loss of longitudinal arch → pes planus and heel valgus<br>• Palpable pain between medial malleolus and navicular<br>• Pain in the plantar medial arch <br>[[Image:Pes planus.JPG]]<br> | ||
== Differential Diagnosis == | == Differential Diagnosis == |
Revision as of 13:35, 30 December 2012
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Search Strategy[edit | edit source]
Databases Searched: Pubmed, ADB, web of knowledge, PEDro, The Journal of Joint and Bone Surgery, Dynamed, PhysioAdvisor
Keyword Searches: tibialis posterior tendon (TPT) , tibialis posterior rupture (TPR), tibialis posterior tendon rupture (TPTR), TPTR treatment, TPTR postoperative treatment, flatfoot, pes planovalgus, tendinitis
Definition/Description[edit | edit source]
Whenever the tibialis posterior muscle contracts or is stretched, tension is placed through the tibialis posterior tendon. If this tension is excessive due to too much force or repetition, damage to the tibialis posterior tendon may occur. This can range from minor tearing of the tendon with subsequent inflammation to a complete tibialis posterior tendon rupture. Early diagnosis and surgical repair will restore full normal function. [1]
A rupture of the posterior tibial tendon can be easily missed because the symptoms of this injury resemble the symptoms of a normal ankle sprain. Some physicians may feel that posterior tibial tendon rupture is a rare condition, one that they have never seen.
Clinically Relevant Anatomy[edit | edit source]
Epidemiology /Etiology[edit | edit source]
Posterior tibialis tendon ruptures occur predominantly in the late middle-aged population (average age 57 years). For posterior tibialis dysfunction, the patient is typically a female over the age of 40 who exhibits ligamentous laxity in multiple joints and has an occupation that requires extended periods of standing. They usually do not recall any acute traumatic event. There is another subset of the populations in which posterior tibial tendon insufficiency occurs and that consists of the 20- to 40-year old athletes. They usually recall a traumatic event, usually a direct blow to the medial malleolus. Or, they present with years of involvement in athletics with a pronated foot.Cite error: Invalid <ref>
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Characteristics/Clinical Presentation[1][edit | edit source]
• Swelling along the medial aspect of the foot and ankle
• Absence of the classical sudden severe pain of a tendon rupture
• Tenderness along the posterior tibialis tendon
• Progressive loss of longitudinal arch → pes planus and heel valgus
• Palpable pain between medial malleolus and navicular
• Pain in the plantar medial arch
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
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Physical Therapy Management
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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