Abstract
Posterior tibial tendon dysfunction (PTTD) is a debilitating and painful musculoskeletal condition seen in both the adult and pediatric patient populations. Stage II PTTD is commonly treated with periarticular osteotomies due to its flexible nature and generally minimal arthritic changes of the subtalar or talonavicular joints. Commonly a flexor digitorum longus tendon transfer is incorporated into the reconstruction to support the medial column and replace the functionally incompetent posterior tibial tendon. To support this transfer and correct for forefoot abduction and calcaneus valgus, a lateral column lengthening osteotomy or a multi-planar calcaneal Z osteotomy can be utilized to correct the pes planovalgus deformity. This chapter focuses on in-depth surgical reconstruction techniques for the traditional lateral column lengthening, calcaneal Z osteotomy, and anterior calcaneal Z osteotomy for the correction of flexible pes planus deformity correction.
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