Posterior Tibial Tendon Classification Flashcards

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Questions and Answers

What is the name of the classification for Posterior Tibial Tendon Dysfunction?

Johnson & Strom - 1989 (correct)

Mueller - 1991

Rosenberg - 1988

Myerson - 1997 (correct)

What is Johnson & Strom Type I characterized by?

Medial pain, tenosynovitis, mild weakness on heel-raise test

What are the symptoms of Johnson & Strom Type II?

Medial/lateral pain, tendon elongation, flexible pes planus, weakness on heel raise, + too many toes sign

What characterizes Johnson & Strom Type III?

Medial/lateral pain, tendon degeneration, fixed pes planus, no inversion on heel raise, + too many toes sign, STJ arthritis Signup and view all the answers

What symptoms are associated with Johnson & Strom Type IV?

Medial/lateral pain, tendon degeneration, fixed pes planus, no inversion on heel raise, + too many toes sign, STJ arthritis, Valgus talus, Ankle arthritis Signup and view all the answers

What is Myerson's classification for tenosynovitis?

Myerson - Tenosynovitis Signup and view all the answers

What are the symptoms of a Myerson Stage I Rupture?

Medial pain and swelling, hindfoot flexible, can perform heel-rise Signup and view all the answers

What characterizes a Myerson Stage II Rupture?

Valgus angulation of heel, lateral pain, hindfoot flexible, cannot perform heel-rise Signup and view all the answers

What is the feature of Myerson Stage III Rupture?

Valgus angulation of heel, lateral pain, hindfoot rigid, cannot perform heel-rise Signup and view all the answers

Describe Myerson Stage IV Rupture.

Hindfoot rigid, valgus angulation of talus Signup and view all the answers

What is the classification of Posterior Tibial Tendon Rupture?

All of the above Signup and view all the answers

What characterizes Mueller Type I?

Direct injury Signup and view all the answers

What does Mueller Type II relate to?

Rupture secondary to systemic disease Signup and view all the answers

What is Mueller Type III classified as?

Idiopathic Signup and view all the answers

What does Mueller Type IV indicate?

Rupture secondary to mechanical dysfunction Signup and view all the answers

Describe Conti Stage I.

One or two fine, longitudinal tears Signup and view all the answers

What are the characteristics of Conti Stage II?

Intramural degeneration, variable diameter, wide longitudinal tears Signup and view all the answers

What is defined as Conti Stage III?

Scarring in tendon, complete tear Signup and view all the answers

What characterizes Rosenberg Stage I?

Hypertrophic tears in tendon (appears bulbous) Signup and view all the answers

Describe the features of Rosenberg Stage II.

Atrophic tears Signup and view all the answers

What defines Rosenberg Stage III?

Complete tear Signup and view all the answers

Study Notes

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.

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Description

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.