An adult flexible flatfoot patient fails conservative management. Which tendon is most commonly reconstructed/transferred in surgical correction of adult-acquired flatfoot deformity (AAFD) Stage II?
- A Peroneus longus tendon
- B Tibialis posterior tendon augmented with flexor digitorum longus (FDL) transfer ✓
- C Tibialis anterior tendon
- D Flexor hallucis longus (FHL) tendon alone
Correct answer: B. Tibialis posterior tendon augmented with flexor digitorum longus (FDL) transfer
Explanation
Stage II AAFD is characterised by tibialis posterior tendon dysfunction (tendinosis/partial tear) causing flexible flatfoot. Surgical treatment involves debridement of the TP tendon combined with FDL tendon transfer to the navicular to augment medial arch support, typically combined with a calcaneal osteotomy (medialising or lateral column lengthening) to correct hindfoot valgus. FDL transfer alone without bony correction has inferior outcomes. The other tendons listed do not restore the medial arch mechanism.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.