This is one of the more common tendon disorders about the ankle. Posterior Tibial Tendon Dysfunction (PTTD) is an alteration of the function of the posterior tibial tendon. This may be due to a rupture, laceration, inflammation, abnormal insertion, or attenuation of the tendon. With dysfunction of the tendon there can be excessive pronation of the foot and an acquired flatfoot.
The posterior tibial tendon helps support the arch of the foot and provides power to point the foot down and to turn the foot inward.
Posterior tibial tendon dysfunction is usually pain with walking/standing as well as a noticeable flatting of the foot while walking/standing. There maybe increased shoe irritation in the arch of the foot as the foot is allowed to excessively pronate or roll inward.
Patients often experience tenderness and inflammation along the inner part of the ankle. They note weakness when standing on their toes.
As the disease progresses, patients describe loss of the arch of the foot while standing. Patients often note continued pain and inflammation. The foot tends to turn outward with weight bearing.
Late stage disease includes a flat foot deformity with degenerative changes in the joints below the ankle.
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