How to Treat PTTD (Posterior Tibial Tendon Dysfunction) by Dr. Patrick DeHeer, DPM

Diagnosis - Ankle Injury

Posterior Tibial Tendon Dysfunction (PTTD) – Stages II-IV

Patient

Typically, middle aged patients 40-60 years old

Treatment Protocol

Stage II Flexible Deformity

The TayCo® Acute XAB Brace provides the ability to use a custom, disease specific in the shoe orthotic to provide corrective support to the foot with the Acute XAB Brace providing ankle and lower leg support, specifically to the deltoid ligament complex and to the posterior tibial tendon originating in the lower leg (Custom or Acute based on deformity, Brace typically dispensed Fixed).

Stage III Rigid Deformity

The Acute XAB Brace provides the ability to use an accommodative orthotic to provide some support to the foot with the Acute XAB Brace providing ankle and lower leg support, specifically to the deltoid ligament complex and to the posterior tibial tendon originating in the lower leg. Brace typically dispensed Fixed.

Stage IV Deformity

The Acute XAB Brace provides the ability to use a custom, disease specific in-the-shoe orthotic to provide corrective support to the foot for flexible deformities. Or an accommodative orthotic to provide some support to the foot for rigid deformities with the Acute XAB Brace providing ankle and lower leg support, specifically to the deltoid ligament complex (which is attenuated in this stage) and to the posterior tibial tendon originating in the lower leg. Brace typically dispensed Fixed.

Outcomes

The Acute XAB Brace provides an excellent ankle foot orthoses (AFO) option for patients requiring ankle and foot stabilization or immobilization that attaches to a shoe instead of being put into a shoe. Many AFOs are challenging to fit into the limited space within a shoe. By attaching to the shoe externally, the Acute XAB Brace is an effective, user-friendly device. Additionally, the Acute XAB Brace allows for the use of a custom or accommodative orthoses. With the Acute XAB Brace, patients experience earlier return to function, better compliance, and better satisfaction relative to competitive products. Patient outcomes also improved, mainly due to compliance. The Acute XAB is also a good non-surgical option, or can be a conservative option before treatment.

- By Dr. Patrick DeHeer, DPM Upperline Health Indiana, Consulting Physician for the Indiana Pacers Dr. DeHeer earned a doctor of podiatric medicine degree from the Dr. William M. Scholl College of Podiatric Medicine in Chicago, and completed his residency in podiatric surgery at Winona Memorial Hospital in Indianapolis and a fellowship in foot and ankle arthroscopy under one of the most innovative and well-known podiatrists in Indianapolis, Richard O. Lundeen, DPM. Dr. DeHeer is a leading expert and international speaker for modern podiatry care.