[Tibialis posterior tendon transfer for drop foot deformity].

OBJECTIVES

We evaluated tibialis posterior tendon (TPT) transfers in patients with drop foot deformity.

METHODS

Eight patients with drop foot deformity (2 females, 6 males; mean age 40 years; range 15 to 75 years) underwent TPT transfer to the dorsum of the foot. The deformity was on the left in three patients and on the right in five patients. Etiology was traumatic peroneal nerve injuries in six patients, and upper-level nerve injuries after hip and lumbar surgery in two patients. For clinical evaluation, the patients were questioned about the results of treatment, and the Stanmore evaluation scale was applied, which is recommended by Yeap et al. for TPT transfers. The mean follow-up period was 39 months (range 8 to 78 months).

RESULTS

According to the Stanmore scale, the results were excellent in three patients, good in two patients, fair in two patients, and poor in one patient. Subjectively, four patients defined their condition as excellent, three as good, and one as poor. One poor result was associated with polytrauma sequelae including a femoral fracture, posterior acetabular fracture-dislocation, and L3 compression fracture, accompanied by at least a two-level injury to the sciatic nerve. Of two patients with a fair result, one patient developed deep infection at the dorsum of the foot due to inadequate postoperative care and required removal of the suture anchor with partial bone debridement. The other patient had severe paraparesis associated with congenital spondylolisthesis, which aggravated following spinal fusion surgery.

CONCLUSION

We conclude that TPT transfer is a successful technique for the treatment of drop foot even in ambulatory patients with paraparesis. Addition of tibialis anterior tendon transfer may be useful in these patients.