An adult patient with stage IIB posterior tibial tendon dysfunction (PTTD) is best managed by:

• A Orthotics and physiotherapy alone
• B Isolated FDL tendon transfer
• C Triple arthrodesis
• D FDL tendon transfer with medial displacement calcaneal osteotomy ✓

Explanation

Johnson & Strom stage IIB PTTD represents a flexible flatfoot deformity with moderate hindfoot valgus (>10°) and forefoot abduction. FDL (flexor digitorum longus) tendon transfer alone corrects the tendon deficiency but does not address the hindfoot valgus and undercorrects the deformity. Adding a medial displacement calcaneal osteotomy (Myerson modification) redirects the heel and reduces tension on the repair. Triple arthrodesis is reserved for rigid deformity (Stage III/IV).

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.