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Can Tho Transfer Technique: Extensor Hallucis Longus to Tibialis Anterior Tenodesis for Footdrop
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Background
Footdrop, or the inability to actively dorsiflex the foot, may result from numerous pathologic conditions, including poliomyelitis and cerebral palsy. Although the gait of patients with footdrop can be improved by performing an extensor hallucis longus (EHL) to tibialis anterior (TA) tendon transfer, the success rate of this procedure is relatively low.
Methods
Seven paralytic patients with footdrop were surgically treated using a new buttonhole-type technique that involves passing a loop of the EHL through a TA split using umbilical tape and suturing at the four corners of the EHL attaching to the TA while the foot is dorsiflexed.
Results
Eight years after surgery, all three patients who were available for follow-up displayed active dorsiflexion, improved mobility, and a palpable TA-EHL tenodesis, with no cockup deformity.
Conclusions
This new approach, which we term Can Tho transfer, improves the mechanical strength of TA-EHL tenodesis.
Orthopedics Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Community Medical Center, Stockton, CA.
Orthopedic Department, Can Tho Central General Hospital, Can Tho City, Vietnam.
Veteran Affairs Palo Alto Health Care System, Palo Alto, CA.
S.O.A.R. Sport Orthopedics and Rehabilitation, Redwood City, CA.
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