Abstract
Posterior tibial tendon dysfunction (PTTD) often leads to adult acquired flatfoot deformity. Loss of the tendon’s invertor function results in a progressively lower medial longitudinal arch, hindfoot valgus and forefoot abduction. Treatment varies based on surgeon preference, but typically consists of a medial slide calcaneal osteotomy (slide) and a flexor digitorum longus (FDL) tendon transfer. The concept of a medial displacement calcaneal osteotomy with a posterior distraction (distraction) has been introduced, and demonstrated to significantly reduce the inversion force requirement for heel rise compared to the slide[l]. This finding is significant as it suggests that the distraction is more efficacious than the slide in correcting deformity. However, it has not been validated on a flatfoot model.
