- Discussion:
- following lengthening or rupture of tibialis posterior, pt will develop fixed hindfoot deformity w/ hindfoot valgus and forefoot in abduction;
- if site of maximal deformity is at talonavicular joint, then an isolated talonavicular or talonavicular & calcaneocuboid may be performed;
- sub-talar arthrodesis:
- w/ more significant hindfoot valgus, subtalar arthrodesis may be indicated.
- note that complete correction of the hindfoot deformity may cause a relative supination deformity of the forefoot (which in turn,
decreases the relative amount of wt bearing of the first metatarsal);
- triple arthrodesis:
- indicated only w/ severe midfoot collapse deformities;
- achilles tendon lengthening will often be required for equinus deformity