Calcaneal Osteotomy and Flexor Digitorum Longus Transfer for Stage II Posterior Tibial Tendon Insufficiency

The diagnosis and treatment of posterior tibial tendon dysfunction can be difficult. This article discusses the diagnosis and treatment of stage II posterior tibial tendon dysfunction and specifically elucidates a cogent approach to when and how to do a calcaneal osteotomy and flexor digitorum longus transfer. We present 2 different methods by which the flexor digitorum longus transfer can be completed, the first using a bone tunnel through the navicular and the second using bioabsorbable screws. We also discuss the postoperative protocol used after treatment.