Fig. 1

A 3–4 cm longitudinal incision was made along the medial foot to expose only the PTT insertion and accessory navicular (A). In addition to accessory navicular resection, the PTT insertion was cleared, and the medial surface of the navicular plantar was modified to a coarse surface to adjust the PTT tension (B). The sutured anchors were used to fix the PTT to the anterior-inferior site to the tubercle of the navicular bone (C). The arch was lifted, and the foot was placed supinely during suturing to restore the alignment direction of PTT and improve the longitudinal arch