Tibialis posterior (TP) tendon transfer for foot drop: A single center experience

Abstract

Background: Foot drop defined as a significant weakness of ankle and toe dorsiflexion. It leads to high stepping gait, functional impairment and deformity of the foot. Objective of this study was to assess the functional outcome of tibialis posterior (TP) transfer for patient with foot drop in a single center. Methods: This is a retrospective study included 20 patients operated for foot drop of >1 year duration in the last 5 years. Preoperative assessment of muscles of all the three compartment of leg along with radiological assessment of ankle to rule out tarsal disintegration and ankle instability was done. Postoperatively gait, active dorsi/plantar flexion and the range of movement of the ankle and toes were assessed. Results: Tibialis posterior transfer was performed on 20 patients (16 males and 4 females, mean age 31.4 years). Commonest cause of foot drop was Hansen's disease followed by post traumatic peroneal nerve damage and post injection sciatic neuropathy. At mean follow-up of 2 years, all patients, except one, could walk with heel-toe gait without any orthotic support. There was no pain, ruptures or infections of the transferred tendons. 19 of the 20 operated ankles had mean active dorsiflexion of 7.5 , the active plantar flexion of 36.25 , and the total range of movement 43.75 . The active dorsiflexion of the toes ranged from 5-20 . Conclusion: Dynamic tibialis posterior transfer gives good results in terms of normal gait, high patients' satisfaction with minimal donor site morbidity and low complication rate.

A Systematic Review of Muscle Synergies during a Walking Gait to Define Optimal Donor-Recipient Pairings for Lower Extremity Functional Reconstruction

“…Transfer of the tibialis posterior (TP) tendon has been described to stabilize the ankle and statically clear the toes during swing. 17 Although this is generally an improvement, the TP transfer does not restore active dorsiflexion, as the TP naturally performs an antagonistic function. Therefore, our preference is to combine a tendon transfer of the lateral head of gastrocnemius into the TA with simultaneous transfer of its nerve into the proximal peroneal nerve (Table 2 ).…”

The sub-specialty of foot and ankle is evolving fast

“…To showcase the importance of foot and ankle disorders, we have included several high-quality reviews and original research articles, annotations, along with some very interesting case reports and technical tips. The variety of publications, in this special issue, range from fractures, 4,5 arthritis, 6 diabetic foot problems, 7,8 tendon transfer for the foot drop, 9 hallux valgus, club foot and Morton's neuroma. There are also articles on ultrasound-guided regional anaesthesia in foot and ankle surgery and on postoperative rehabilitation.…”

Posterior Tibial Tendon Transfer for the Correction of Drop Foot

“…Our outcomes were comparable to the study by Yeap et al, 6 who reported 10 of 12 patients no longer required the use of an orthosis following PT tendon transfer for drop foot. Agarwal et al 20 published similar results and reported that all of their patients, except for one, were able to walk with heel-toe gait without any orthotic support postoperatively.…”