Orthonotes
Orthonotes
by the.bonestories
v3.0 Fusion
v3.0 Fusion
general topic hub

Adult Acquired Flatfoot — Posterior Tibial Tendon Dysfunction (PTTD)

Most common cause of adult acquired flatfoot; due to PTT degeneration/rupture. Stages I–IV (Johnson & Strom classification). Clinical: medial ankle pain, progressive collapse of medial arch, hindfoot valgus. Imaging: MRI shows tendon degeneration; weight-bearing X-rays show arch collapse. Treatment: Stage I—orthoses, NSAIDs; Stage II—tendon transfer + osteotomy; Stage III/IV—arthrodesis.

Overview

Topic summary

View wiki
Most common cause of adult acquired flatfoot; due to PTT degeneration/rupture. Stages I–IV (Johnson & Strom classification). Clinical: medial ankle pain, progressive collapse of medial arch, hindfoot valgus. Imaging: MRI shows tendon degeneration; weight-bearing X-rays show arch collapse. Treatment: Stage I—orthoses, NSAIDs; Stage II—tendon transfer + osteotomy; Stage III/IV—arthrodesis.
MCQs

High-yield practice questions

Start topic quiz
Question 1

What is the most common cause of adult acquired flatfoot deformity?

Question 2

In the Johnson & Strom classification, what characterizes Stage I PTTD?

Question 3

Which of the following is NOT a risk factor for developing posterior tibial tendon dysfunction?

Question 4

What is the primary clinical sign indicating forefoot abduction in adult acquired flatfoot?

Question 5

Which imaging modality is best to assess tendon degeneration in PTTD?

Question 6

What is the recommended initial treatment for Stage II PTTD?

Question 7

In Stage III PTTD, which of the following is likely to be observed?

Question 8

What is the appropriate surgical intervention for Stage IV PTTD with tibiotalocalcaneal involvement?

Question 9

Which clinical test assesses the ability of the posterior tibial tendon to support the medial arch?

Question 10

What is the significance of the 'too many toes' sign in PTTD?