Traditional treatment for stage II posterior tibial tendon (PTT) dysfunction includes flexor digitorum longus (FDL) transfer combined with various osteotomies. However, the FDL has been shown to be much weaker than the PTT and thus may not be the ideal tendon for transfer. Furthermore, the peroneus brevis continues to be a deforming force following reconstructive surgery and may contribute to recurrent deformity. This paper presents a novel technique consisting of posterior tibial tendon reconstruction with allograft and peroneus brevis to longus transfer combined with various osteotomies necessary for correction. Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence.

This novel technique combining allograft reconstruction, peroneus brevis to longus transfer, and various osteotomies effectively treats posterior tibial tendon rupture, improving outcomes and reducing recurrence.

Management of Posterior Tibial Tendon Rupture With Allograft Reconstruction, Osteotomy, and Peroneus Brevis to Longus Transfer

Key Takeaway: This novel technique combining allograft reconstruction, peroneus brevis to longus transfer, and various osteotomies effectively treats posterior tibial tendon rupture, improving outcomes and reducing recurrence.