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The tibialis posterior tendon footprint: an anatomical dissection study
BACKGROUND: The tibialis posterior tendon (TPT) is the main dynamic stabilizer of the medial longitudinal arch of the foot. Especially in adult acquired flatfoot deformity (AAFD) the TPT plays a detrimental role. The pathology and function of the tendon have been extensively investigated, but knowle...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236122/ https://www.ncbi.nlm.nih.gov/pubmed/32430082 http://dx.doi.org/10.1186/s13047-020-00392-1 |
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author | Willegger, Madeleine Seyidova, Nargiz Schuh, Reinhard Windhager, Reinhard Hirtler, Lena |
author_facet | Willegger, Madeleine Seyidova, Nargiz Schuh, Reinhard Windhager, Reinhard Hirtler, Lena |
author_sort | Willegger, Madeleine |
collection | PubMed |
description | BACKGROUND: The tibialis posterior tendon (TPT) is the main dynamic stabilizer of the medial longitudinal arch of the foot. Especially in adult acquired flatfoot deformity (AAFD) the TPT plays a detrimental role. The pathology and function of the tendon have been extensively investigated, but knowledge of its insertional anatomy is paramount for surgical procedures. This study aimed to analyze the complex distal footprint anatomy of the TPT. METHODS: Forty-one human anatomical specimens were dissected and the distal TPT was followed to its bony footprints. After tendon removal the footprints were marked with ink. Standardized photographs were taken and consecutively analyzed by digital imaging measurements. Footprint length, width, area of insertion, location, and shape was studied regarding the main insertion at the navicular bone. RESULTS: All specimens had the main TPT insertion at the navicular bone (41/41, 100%). Sixty-three percent of navicular TPT insertions were located at the plantar aspect. The mean navicular footprint measured 12.1 mm × 6.9 mm in length and width, respectively. The tendon further spread into several slips which anchored the tibialis posterior deep in the plantar arch. TPT insertions were highly variable with an involvement of up to eight distinct bony footprints in the mid- and hindfoot. The second most common additional footprint was the lateral cuneiform (93% of dissected feet), followed by the medial cuneiform (80%), the metatarsal bases [1–5] (80%), the cuboid (46%), the intermediate cuneiform (19%), and the calcaneus (12%). CONCLUSIONS: The present study adds to current knowledge on the footprint anatomy of the TPT. Based on the findings of this study we advocate a plantar location of flexor digitorum longus tendon transfer in flexible AAFD in order to restore the anatomical lever and insertion of the TPT. |
format | Online Article Text |
id | pubmed-7236122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72361222020-05-27 The tibialis posterior tendon footprint: an anatomical dissection study Willegger, Madeleine Seyidova, Nargiz Schuh, Reinhard Windhager, Reinhard Hirtler, Lena J Foot Ankle Res Research BACKGROUND: The tibialis posterior tendon (TPT) is the main dynamic stabilizer of the medial longitudinal arch of the foot. Especially in adult acquired flatfoot deformity (AAFD) the TPT plays a detrimental role. The pathology and function of the tendon have been extensively investigated, but knowledge of its insertional anatomy is paramount for surgical procedures. This study aimed to analyze the complex distal footprint anatomy of the TPT. METHODS: Forty-one human anatomical specimens were dissected and the distal TPT was followed to its bony footprints. After tendon removal the footprints were marked with ink. Standardized photographs were taken and consecutively analyzed by digital imaging measurements. Footprint length, width, area of insertion, location, and shape was studied regarding the main insertion at the navicular bone. RESULTS: All specimens had the main TPT insertion at the navicular bone (41/41, 100%). Sixty-three percent of navicular TPT insertions were located at the plantar aspect. The mean navicular footprint measured 12.1 mm × 6.9 mm in length and width, respectively. The tendon further spread into several slips which anchored the tibialis posterior deep in the plantar arch. TPT insertions were highly variable with an involvement of up to eight distinct bony footprints in the mid- and hindfoot. The second most common additional footprint was the lateral cuneiform (93% of dissected feet), followed by the medial cuneiform (80%), the metatarsal bases [1–5] (80%), the cuboid (46%), the intermediate cuneiform (19%), and the calcaneus (12%). CONCLUSIONS: The present study adds to current knowledge on the footprint anatomy of the TPT. Based on the findings of this study we advocate a plantar location of flexor digitorum longus tendon transfer in flexible AAFD in order to restore the anatomical lever and insertion of the TPT. BioMed Central 2020-05-19 /pmc/articles/PMC7236122/ /pubmed/32430082 http://dx.doi.org/10.1186/s13047-020-00392-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Willegger, Madeleine Seyidova, Nargiz Schuh, Reinhard Windhager, Reinhard Hirtler, Lena The tibialis posterior tendon footprint: an anatomical dissection study |
title | The tibialis posterior tendon footprint: an anatomical dissection study |
title_full | The tibialis posterior tendon footprint: an anatomical dissection study |
title_fullStr | The tibialis posterior tendon footprint: an anatomical dissection study |
title_full_unstemmed | The tibialis posterior tendon footprint: an anatomical dissection study |
title_short | The tibialis posterior tendon footprint: an anatomical dissection study |
title_sort | tibialis posterior tendon footprint: an anatomical dissection study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236122/ https://www.ncbi.nlm.nih.gov/pubmed/32430082 http://dx.doi.org/10.1186/s13047-020-00392-1 |
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