Hintermann B
Orthopädische Universitätsklinik, Kantonsspital Basel.
Orthopade. 1995 Jun;24(3):193-9.
The mechanical integrity of the arch of the foot depends on static and dynamic factors. The posterior tibial tendon in particular is situated to provide dynamic support along the medioplantar aspect of the foot and arch. Tibialis posterior dysfunction is a progressive condition leading to a painful flatfoot deformity. To understand changes that occur in the pathological state, a clear analysis of the normal function of the tibialis posterior is necessary. Early diagnosis of posterior tibialis dysfunction is crucial for preventing a progressive deformity. For diagnosis, clinical findings are predominant. When passive correction of the foot deformity is still possible, a reconstruction of the tendon should be attempted. As retraction of the tendon ends or degeneration prevents primary repair, tendon transfer may substitute for the posterior tibial tendon. When a fixed flatfoot has developed, realignment by arthrodesis is advised. Triple arthrodesis may be appropriate to correct hindfoot valgus as well as forefoot abduction.
足弓的机械完整性取决于静态和动态因素。特别是胫后肌腱，其位置可沿足内侧跖面和足弓提供动态支撑。胫后肌腱功能障碍是一种渐进性疾病，会导致疼痛性扁平足畸形。为了解病理状态下发生的变化，有必要对胫后肌的正常功能进行清晰分析。胫后肌腱功能障碍的早期诊断对于预防渐进性畸形至关重要。诊断主要依据临床症状。当仍可被动矫正足部畸形时，应尝试重建肌腱。由于肌腱末端回缩或退变妨碍一期修复，肌腱转移可替代胫后肌腱。当出现固定性扁平足时，建议通过关节融合术进行矫正。三关节融合术可能适合矫正后足外翻以及前足外展。
