Patients with posterior tibial tendon insufficiency as result of attritional loss of continuity. Note that one or more of three major components of deformity may be excessive. A, Right heel is in some valgus and forefoot is pronated, but note marked midfoot abduction. This is important to note because not only would tendon transfer-substitute for posterior tibial tendon not correct this deformity, but also subtalar arthrodesis with heel in neutral would leave this component uncorrected. B, Standing position emphasizes multiple-plane deformity. C, Note convexity of medial side and concavity of lateral side on left foot.