Summary We have operated on 25 patients for correction of foot-drop due to leprosy from March 1992 to July 1994. The method used was circumtibial transfer of the tibialis posterior to the tendons of extensor hellucis longus and the extensor digitorum longus in the fo ot together with lengthening of the Achilles tendon. The results were satisfactory in 20 of these cases as judged by adequate restoration of heel-toe gait and of active dorsiflexion. The follow-up period ranged from 6 months to 2 years. Inadequate post-operative physiotherapy was the reason for unsatisfactory results in five cases.It is well recognized that correction of fo ot-drop deformity in leprosy is essential to ensure normal walking and to prevent plantar ulcerations. This paper describes the procedure adopted and the results of surgical correction of fo ot-drop due to leprosy in 25 patients at the Leprosy Control Institute and Hospital, Mohakhali, Dhaka in Bangladesh. The procedure adopted was the transfer of the tendon of the tibialis posterior muscle to the extensor tendons of the toes in the fo ot so as to ensure active dorsiflexion of the fo ot. 1-3 Material and methodsIn the Institute between March 1992 and July 1994 we saw 34 patients with fo ot-drop due to leprosy. Nine of these were treated conservatively and 25 were treated surgically. Of these 25 patients 20 were male and 5 female. Their ages ranged fr om 12 to 45 years. Contracture of the Achilles tendon was present in all cases. The fo llow-up period was 6 months to 2 years.

IntroductionReconstruction of large defect of tibia following infection is considered as one of the most difficult problem facing the orthopaedic surgeon. Amputation with modern prosthetic fitting is a salvage procedure to treat big defects, which gives a functional result with unpredictable psychological impact.Materials & MethodsBetween January 2000 and January 2021, 56 patients (30 males and 26 females) with big defects following infection and post traumatic injury of the tibia were treated. The mean age of the patients at the time of surgery was 20.5 years (4–24 years). The fibula was mobilized medially to fill the defect and was fixed with Ilizarov fixator. The average size of the defects reconstructed was 18.5 cm (17–20 cm).ResultsThe average time for complete union was 8.6 months (range, 5–9 months). At final follow-up all patients had fully united. We found leg length discrepancy in 52 patients and that was corrected by re-lengthening of the solid new regenerate boneConclusionsThe Ilizarov method has been shown to be an effective method of treating Tibialization of fibula for reconstruction of big tibial defects.