Tibialis Posterior Tendon Transfer for Persistent Drop Foot after Peroneal Nerve Repair


Oezkan T., Tuncer S., Ozturk K., Aydin A. , Ozkan S.

JOURNAL OF RECONSTRUCTIVE MICROSURGERY, vol.25, no.3, pp.157-164, 2009 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 3
  • Publication Date: 2009
  • Doi Number: 10.1055/s-0028-1103502
  • Title of Journal : JOURNAL OF RECONSTRUCTIVE MICROSURGERY
  • Page Numbers: pp.157-164

Abstract

Despite advances in the surgical treatment of peroneal nerve injuries, a significant fraction of patients do not recover adequately. Among 35 patients who had previous repair of the peroneal nerve, 19 had permanent drop foot, and 16 of these patients underwent tibialis posterior (TP) tendon transfer. Mean duration of paralysis was 26.7 (range, 7 to 192) months. TP tendon was carried to the anterior compartment via the circumtibial route, and then attached to the tibialis anterior, extensor hallucis longus, extensor digitorum communis, and peroneus tertius tendons using tendon-tendon anastomosis. All patients except for one achieved active dorsiflexion to or beyond neutral. Mean preoperative drop foot angle increased from -33.8 degrees to + 9.7 degrees. According to the Stanmore system, the results were excellent in 10 patients (62.5%), good in 4 (25.0%), fair in 1 (6.2%), and poor in 1 (6.2%). The average Stanmore score was 85, which corresponded to an excellent result. We believe that the TP tendon transfer is a straightforward and reliable solution in the treatment of drop foot.