Variations in the insertions of the tibialis posterior muscle and the structure of the medial longitudinal arch
Master Thesis
2014
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University of Cape Town
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Abstract
This study utilized cadavers to examine the variable insertions of the tendon of tibialis posterior muscle. Both feet from 29 cadavers were dissected and six variable connections to intrinsic foot structures were documented (frequencies indicated as a per cent): sustentaculum tali (93.1%), abductor hallucis muscle (44.8%), flexor hallucis brevis muscle (22.4%), fibularis longus tendon (58.6%), plantar calcaneonavicular (spring) ligament (17.2%), and the long plantar ligament (34.5%). The frequencies for each variable insertion were also reported individually for sex and population group, as well as the most common combinations of insertions. Measurements describing the medial longitudinal arch of the feet were taken, using a soft tissue intact method (arch index) and the post-dissection method (talus-first metatarsal angle). The insertion data were then compared to the arch measurements, as well as foot side, age, sex, and population group. There was a weak negative correlation between the talus-first metatarsal angle measurement and the presence of an insertion on to sustentaculum tali, as well as a connection to the tendon of fibularis longus. Arch measurements were shown to be statistically significantly similar for left and right feet for each individual. Knowing the arch index on one side of the body allows for an accurate prediction of the arch index on the opposite side within an individual. The right arch index was larger in 55% of the sample. All other correlations were negligible, and the presence or absence of specific insertions was not an accurate predictor of either arch measure. The accumulation of multiple variable insertions did not have any impact on the arch measurements.
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Includes bibliographical references.
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Sadler, M. 2014. Variations in the insertions of the tibialis posterior muscle and the structure of the medial longitudinal arch. University of Cape Town.