Posterior Tibial Tendon Classification Flashcards

Posterior Tibial Tendon Dysfunction Classification

• Johnson & Strom (1989) and Myerson (1997) established classifications for Posterior Tibial Tendon Dysfunction.
• Key features include symptom progression and clinical findings across four main types.

Johnson & Strom Classification

• Type I:

  • Characterized by medial pain, tenosynovitis, and mild weakness on heel-raise test.

• Type II:

  • Medial and lateral pain, tendon elongation, flexible pes planus, significant weakness on heel raise, and positive "too many toes" sign.

• Type III:

  • Medial and lateral pain, tendon degeneration, fixed pes planus, absence of inversion on heel raise, positive "too many toes" sign, and subtalar joint (STJ) arthritis.

• Type IV:

  • Similar to Type III but includes valgus talus and ankle arthritis, along with medial/lateral pain and degeneration.

Myerson Classification for Tenosynovitis and Ruptures

• Tenosynovitis:

  • Acute medial pain and swelling with heel-rise capability. Treated conservatively with anti-inflammatories or operatively with tenosynovectomy or related procedures.

• Stage I Rupture:

  • Medial pain and swelling, hindfoot flexibility, can perform heel-rise. Treatment options consist of orthotic supports and tendon debridement.

• Stage II Rupture:

  • Valgus angulation of heel, lateral pain, flexible hindfoot, unable to perform heel-rise. Treatment includes specialized orthotics or surgical tendon transfers.

• Stage III Rupture:

  • Fixed valgus angulation and rigid hindfoot with inability to perform heel-rise. Recommended treatment is a rigid orthosis or triple arthrodesis.

• Stage IV Rupture:

  • Rigid hindfoot with valgus angulation of talus. Treatment options include rigid orthosis or tibiotalocalcaneal arthrodesis.

Mueller and Conti Classifications

• Mueller Classification:

  • Type I: Direct injury.
  • Type II: Rupture due to systemic disease.
  • Type III: Idiopathic rupture.
  • Type IV: Rupture from mechanical dysfunction.

• Conti Classification:

  • Stage I: One or two fine longitudinal tears.
  • Stage II: Intramural degeneration with wide longitudinal tears.
  • Stage III: Scarring in tendon indicating complete tear.

Rosenberg Classification

• Stage I: Hypertrophic tears presenting as bulbous tendon dimensions.
• Stage II: Atrophic tears observed within the tendon.
• Stage III: Complete tendon tear.

Test your knowledge on the classification of posterior tibial tendon dysfunction with these flashcards. Each card presents key terms and definitions from significant studies in the field, helping you to understand the types and characteristics associated with this condition.