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Posterior Tibial Tendon Transfer for the Correction of Drop Foot

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Background

Drop foot is a crippling condition that often requires surgical intervention to restore functional dorsiflexion. Although transfer of the posterior tibial (PT) tendon has been well described for the treatment of drop foot, there is no consensus on whether tendon transfers affecting the ankle joint sufficiently restore functional status for daily activities. In addition, most studies have focused on drop foot caused by peripheral nerve disorders. The purpose of this study was to evaluate the functional outcomes and patient satisfaction following PT tendon transfer for the correction of drop foot resulting from both peripheral and central neurologic causes.

Methods

Patients with drop foot who underwent a PT tendon transfer were followed for a minimum of 1 year and investigated retrospectively. Outcome measures included the American Orthopaedic Foot & Ankle Society ankle and hindfoot scoring system, a patient satisfaction questionnaire, postoperative ankle range of motion, and postoperative ambulatory status.

Results

We evaluated 15 feet in 14 patients at a median follow-up of 50 months. The median postoperative American Orthopaedic Foot & Ankle Society ankle and hindfoot score was 85.0. Thirteen patients (92.9%) reported that they would undergo the procedure again. The median postoperative passive ankle dorsiflexion was 5.0°, and the median postoperative passive ankle plantarflexion was 30.0°. Thirteen patients (92.9%) were able to ambulate postoperatively. Ten (71.4%) ambulated without the use of an ankle-foot orthosis (AFO), and three (21.4%) ambulated with the use of an AFO. Overall, orthoses were able to be discontinued in 73.3% of the cases.

Conclusions

Our results suggest that the PT tendon transfer is an effective procedure for the treatment of drop foot that can improve the patient's functional status and ability to ambulate. The majority of patients were able to discontinue the use of their AFO postoperatively.

Inova Fairfax Medical Campus, Falls Church, VA. Dr. Chung is now with Virginia Foot and Ankle Center, Fairfax, VA. Dr. Dillard is now with Shady Grove Podiatry, Gaithersburg, MD. Dr. Sherick is now with Innovative Medical Solutions, Beverly Hills, CA.

Foot & Ankle Center, PC, Winchester, VA.

Corresponding author: James H. Chung, DPM, Virginia Foot and Ankle Center, 2826 Old Lee Highway, Suite 220, Fairfax, VA 22031. (E-mail: jchung16@gmail.com)