Soft Tissue Procedures for the Stabilization of Medial Arch Pathology in the Management of Flexible Flatfoot Deformity

Soft tissue procedures for the stabilization of symptomatic, advanced hyperpronation deformity are performed most frequently in conjunction with osteotomy, arthrodesis, or arthroereisis of the subtalar joint. A variety of such procedures are available for the selective reinforcement or repair of the posterior tibial tendon, spring ligament, deltoid ligament, or medial intertarsal joint capsules. Recently, the focus has been on the direct repair or reinforcement of the posterior tibial tendon using the long flexor tendons. This article reviews additional procedures that have been of value in the management of posterior tibial tendon dysfunction and the procedures now most commonly employed.