Deltoid ligament repair and augmentation using the posterior tibial tendon during hindfoot arthrodesis in Progressive Collapsing Foot Deformity: A novel technique
Bibliographic record
Abstract
Progressive Collapsing Foot Deformity (PCFD), or Adult Acquired Flatfoot Deformity (AAFFD), leads to medial longitudinal arch collapse and ankle instability, with deltoid ligament insufficiency exacerbating valgus talar tilt. Despite multiple reconstruction methods, an optimal approach remains elusive. This study presents a novel technique for deltoid ligament repair and augmentation using the posterior tibial tendon (PTT) in patients undergoing hindfoot arthrodesis for PCFD. A medial approach is used for both hindfoot fusion and PTT harvesting. The tendon is split into superior and inferior arms, which are utilized to reinforce the tibionavicular and tibiocalcaneal bands. Nonabsorbable sutures and suture anchors secure fixation, while hindfoot fusion is completed using cannulated screws. Postoperative weight-bearing is gradually advanced. This technique improves medial ankle stability while preserving native deltoid ligament tissue. By augmenting the ligament with the PTT, it avoids the risks associated with allografts and donor site morbidity. Preliminary intraoperative and radiographic findings show enhanced coronal and sagittal stability, indicating potential benefits in restoring ankle alignment and function. This novel augmentation strategy offers a promising alternative for managing medial ankle instability in PCFD patients undergoing hindfoot fusion. However, further studies comparing its long-term outcomes to other techniques are essential to validate its efficacy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".