Spontaneous rupture of the tibialis posterior tendon: clinical findings, tenographic studies, and a new technique of repair.

Ten patients with spontaneous rupture of the tibialis posterior tendon were evaluated in regards to clinical and roentgenographic diagnostic criteria, tenographic findings, conservative treatment, and surgical repair. It was concluded that while tenography was a significant diagnostic adjuvant, the diagnosis and decision for surgical intervention must be based primarily upon the clinical findings. Previously described surgical repairs either gave less than optimum results or were impossible to achieve due to the extent of tendon damage. A new surgical technique, consisting of a side to side anastamosis of both the normal proximal and distal portions of the tibialis posterior tendon to the adjacent flexor digitorum longus tendon, proved a simple procedure and gave consistently excellent results.